Integration in Curriculum: Pathway to Comprehensive Learning

1. INTEGRATION I KOJURI J. M.D. CARDIOLOGIST INTERVENTIONIST ASSOCIATE PROFESSOR OF SUMS

2. Definition • In general, all of the definitions of integrated curriculum or interdisciplinary curriculum include: • A combination of subjects • An emphasis on projects • Sources that go beyond textbooks • Relationships among concepts • Thematic units as organizing principles • Flexible schedules • Flexible student groupings. Kojuri J

3. The integrative process must occur within the minds of our students, but the curriculum should be structured to promote that goal. Kojuri J

4. Integration Ladder INTEGRATION Inter-disciplinary Trans-disciplinary Multi-disciplinary Correlation Complementary Sharing Temporal Co-ordination Harmonization Nesting Awareness Kojuri J Isolation

5. Ladder Kojuri J

6. Vertical integration of learning objectives CommunityNeedAssessment RoleDefinition TaskAnalysis ClinicalEducationalNeedAssessment EducationalGoals BasicScienceEducationalNeedAssessment InstructionalObjectives Kojuri J

7. Vertical integration of learning objectives Valvular Heart Diseases are Common In Iran RoleDefinition TaskAnalysis ClinicalEducationalNeedAssessment EducationalGoals BasicScienceEducationalNeedAssessment InstructionalObjectives Kojuri J

8. Vertical integration of learning objectives Valvular Heart Diseases are Common In Iran Diagnosis Initial Treatment And Referral Heart PEx., problem oriented Hx,… Relevant clinical knowledge, skills, … EducationalGoals anatomy and physiology of heart valves, … InstructionalObjectives Kojuri J

9. Intra-course(connected)integration • Within each subject area, course content is connected topic to topic, concept to concept, and relates ideas explicitly. Kojuri J

10. Anatomy Histology Embryology Physiology         1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 Conventional Fragmented Curriculum         1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 Internal Medicine Surgery Pediatrics Gynecology Heart Kidney Kojuri J NervousSystem Lung

11. Synchronized (Sequenced) Integration AnAsynchronizedCurriculum Anatomy Histology Embryology Physiology    1 2 3 4    Time 1 2 3 4  1 2 3 4 1 2 3 4 1 2 3 4  1 2 3 4 1 2 3 4 1 2 3 4 Kidney Heart NervousSystem Lung Kojuri J

12. Synchronized (Sequenced) Integration ASynchronizedCurriculum Anatomy Histology Embryology Physiology         Time 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 Kidney Heart NervousSystem Lung Kojuri J

13. Horizontal integration • Integration of the basic sciences for example: • an organ system approach or • Integration of the clinical sciences for example: • interdisciplinary clerkships Kojuri J

14. Heart Lung Kidney Nervous System   1 2 3 4 1 2 3 4   1 2 3 4 1 2 3 4   1 2 3 4 1 2 3 4   1 2 3 4 1 2 3 4 HorizontalIntegration In BasicScience  Anatomy  Histology Organ System Approach  Embryology  Physiology Kojuri J

15. Horizontalintegration of clinical courses • Some schools divide their clerkships into ambulatory clerkships called: • Ambulatory • primary care • comprehensive care • community-based care • these courses integrate family medicine, obstetrics and gynecology and pediatrics, and inpatient clerkships which are organized by individual departments; e.g., Connecticut. Kojuri J

16. Vertical integration • Vertical integration refers to the interweaving of clinical skills and knowledge into the basic science years and, in turn, reinforcing and continuing to teach basic science concepts as they apply during the clinical years. Kojuri J

17. Conventional unintegrated curriculum Basic Science Clinical Science Kojuri J

18. Vertical distribution of courses Kojuri J

19. Vertical diffusion of content Basic Science Clinical Science Kojuri J

20. Vertical diffusion of content Pure anatomy Anatomy with clinical correlations Clinical anatomy Surgical anatomy Surgery with anatomical correlations Pure surgery Kojuri J

21. Anatomy Histology Embryology Physiology     Heart 1 2 3 4 1 2 3 4 Lung 1 2 3 4 1 2 3 4 Kidney displacementandmerging Nervous System         1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 Physiologyand Internal Medicine AnatomyandSurgery vertical integration of basic and clinical science Kojuri J

22. Earlyexposuretoclinicalsettings • A vast majority of schools expose students to real patients in clinical settings in the first two years, the courses having such names as • doctoring skills • clinical applications of basic science • patient-doctor • physician and society • clinical skills EARLY CLINICAL EXPOSURE CMPETENCY BASED EDUCATION Kojuri J

23. Spiral curriculum • Contentisbrokenintoitssmallestcomponents • Prerequisiteofeachcomponentisdetermined • Instructionofbasicsciencecontentispostponedincurriculumaslongasitispossible • Instructionofclinicalsciencecomponentsarepushedforwardincurriculumaslongasitispossible • horizontalintegrationofcontentsisperformedateachlevel VerticalIntegration HorizontalIntegration Kojuri J

24. Webbed integration • A fertile theme is webbed to curriculum contents and disciplines; subjects use the theme to sift out appropriate concepts, topics, and ideas. Case Problem Theme • Problembasedlearning • Casebasedlearning Kojuri J

25. Threaded model of curriculum integration Skill Skill Curricular Area Curricular Area Curricular Area • Thinking skills, social skills, study skills, and/or the Essential Skills “thread” through all learning. This model of curriculum integration focuses on a meta-curriculum that overlays subject content matter. Kojuri J

26. Integration:teacherandsetting • BasicsciencecontentisthoughtbyaPhDteacherinuniversityclassroom   • ClinicalsciencecontentisthoughtbyaMDteacherinhospital Kojuri J

27. Integration:teacherandsetting • BasicandsomeclinicalsciencecontentisthoughtbyaMD-PhDteacherinuniversityclassroom   Kojuri J

28. Integration:teacherandsetting • Basic and some clinical sciencecontentisthoughtbyjointMD and PhD teams    Kojuri J

29. Integration:teacherandsetting  • clinical and some basic sciencecontentisthoughtbyjointMD and PhD teams   participation of pharmacologists in clinical rounds Kojuri J

30. Integration:teacherandsetting • Simplychangethesettingofbasicscienceteachingtoclinicalones   Kojuri J

31. Shared integration • Shared planning and teaching take place in two disciplines in which overlapping concepts or ideas emerge as organizing elements. Kojuri J

32. Vertical integration in evaluation of educational achievement      conventionalmodel ofevaluation:      anexamaftereach course                Kojuri J     

33. Vertical integration in evaluation of educational achievement or asingleexamatthe endofbasicscience courses   Kojuri J

34. Vertical integration in evaluation of educational achievement verticalintegration bydelayingbasic scienceexam   Kojuri J

35. IntegrationThroughCentralGovernance ofCurriculum           Fragmentedcurriculum,departments,andgovernance Kojuri J

36. IntegrationThroughCentralGovernance ofCurriculum           Curriculum Committee centralgovernanceondifferentdepartments Kojuri J

37. IntegrationThroughCentralGovernance ofCurriculum         Curriculum Committee Interdisciplinary Departments Centralgovernanceonteams,buildbyremovingthe wallsbetweendepartments Kojuri J

38. IntegrationThroughCentralGovernance ofCurriculum         Curriculum Committee Interdisciplinary Departments Integrated Curriculum Centralgovernanceonintegratedteamswhodeliver anintegratedcurriculum Kojuri J

39. Core curriculum • Extracting the core curriculum from curriculum contents and objectives is essential to vertical integration of curriculum Kojuri J

40. Phase I • Literature Research • Advance preparation • Best model for reform 1)Traditional 2) Horizontal integration 3) Vertical integration • Resistance Kojuri J

41. Vision impossible Kojuri J

42. Phase II MalcomSkilbek Situational analysis Kojuri J

43. Phase III • Specialty group formation • Each group one head coordinator • Daily 4-8 hour meeting • Program remerging • Program presentation • Getting special permissions Kojuri J

44. نمای کلی برنامه Kojuri J

45. نمای کلی برنامه Kojuri J

46. اموزش مدولی Kojuri J

47. Phase IV Evaluation Kojuri J

48. الگوی سیپ (CIPP) معرف چهار نوع (مرحله) ارزشیابی می باشد: الف) ارزشیابی زمینه (Context Evaluation) ب) ارزشیابی درونداد (Input Evaluation) ج) ارزشیابی فرایند (Process Evaluation) د) ارزشیابی بازده (Product Evaluation)

49. مدلكركپاتريك مدل دیگر مورد استفاده مدل چهار سطحی کرکپاتریک است.

50. در سطح اول مدل کرکپاتریک، رضايت دانشجويان از برنامه مورد سؤال به عمل آمده و نقات قوت و ضعف برنامه از ديد دانشجويان مشخص مي شود. در سطح دوم ميزان دستيابي به اهداف آموزشي توسط خودسنجي از دانشجويان (SelfAssessment)، سنجش نظرات دانشجويان به صورت گروهي (TeamAssessment) و همچنين امتحانات صورت مي گيرد.امتحانات به صورت Interdisciplinary برگزار شده و بناي آن بر اساس ارائه بازخورد به منظور ارتقاء عملكرد دانشجو است همچنين از نتايج امتحان علوم پايه به عنوان ملاك جامعي براي دستيابي به اهداف آموزشي استفاده خواهد شد. پس از انجام ارزشيابي در اين دو سطح تلاش هايي جهت دستيابي به سطح سوم مدل كريك پاتريك صورت مي گيرد در سطح سوم تغییر در رفتار مورد ارزشیابی قرار می گیرد. در سطح چهارم اندازه گیری پیامد ها مد نظر است.