Medical Education

            AMAL AL-OTAIBI
            CP, MME
vDefine “curriculum”,
vIdentify different types of curricula,
vIdentify the content structures of a curriculum,
vList different educational strategies.
vDefine integration.
vIdentify types of integration
vIdentify rationale for integrated learning
vIdentify the advantages & disadvantages.
  What is a
   What is a curriculum?
• The curriculum is the content or objectives for
  which school hold students accountable.
• The curriculum is the set of instructional strategies
  teachers plan to use.

• These conceptual differences are based on
  distinction between a curriculum as expected end
  of education (Intended learning outcomes),
  and a curriculum as the expected means of
  education (Instructional plans).
What is a curriculum?

• A curriculum is about what should happen in a
  teaching program – about the intension of the
  teachers and about the way they make this

• The curriculum in fact is
    What the student learns
    How the student learns (strategy/s &
     Learning/teaching tools)
    How the student assessed
    The learning environment
    Learning outcomes
Types of Curriculum:

1- The official curriculum: (The written
 “It is documented according to a common theme and to
 successive grade levels with curriculum guide, course
 outlines, and list of objectives.”
qThe purpose is to give
 ØTeachers a basis of planning for lessons and
  assessing students
 ØAdministrators a basis for supervising teachers and
  holding them accountable for their practices and
2-The Operational Curriculum
• What is actually taught by the teachers and how
  it is communicated.

• This includes what the teacher teaches in the
  class and the learning outcome for the students.
3- Hidden Curriculum
• Includes the norms and values of the
  surrounding society.
• It is not part of the either the official or
  operational curricula.
• It has a deeper and durable impact on students.
4- The Null Curriculum

• Subject matters that is not taught at all although
  they appear to be important.
• E.g. Student’s Psychology, Parenting (how to
  teach and care for student).
5- Extra Curriculum

• All planned experiences outside the school
• It contrasts with the official curriculum by its
  responsiveness to students.
• E.g. Sports, social programs, competition
Different curricular models
• Outcome-Based Education- What sort of
  doctor is needed?
    What the doctor able to do
     ØDoing the right thing
    How the doctor approaches his practice
     ØDoing the thing right
    The doctor as a professional
     ØThe right person is doing it
Different curricular models
• Problem-Based Learning
• Task-Based Learning
 ▫ A range of tasks undertaken by a doctor are
   identified. E.g. Management of a patient with
   abdominal pain which is used as the focus for
• An Integrated system-based approach.
• Community-Based Education
Basic curricular structures

• The discrete curriculum,
• The linear curriculum,
• The pyramidal structure, AND
• The spiral curriculum.
Basic curricular structures

• The discrete curriculum
    The self-sufficient programs: unrelated or
     independent contents

         A        B        C        D
The linear curriculum
• Each concept or skill of the content need the
  mastery of the previous concept or skill.
• Called Mastery Learning Strategies

      A          B              C   D

       ▫ Linear Configuration
The pyramidal structure
• Multiple unrelated concepts or skills for learning
  subsequent concepts or skills.

      B                      C

D         E              F         G
The spiral curriculum
• Organization of concepts and skills
• There is interactive revisiting of topics
  throughout the block
• Topics are revisited at numerous levels of
• New learning is strongly related to previous
• The competence of students increases with each
  visit to a topic.
Educational strategies
• Six educational strategies have been identified in
  relation to curriculum in medical schools by Prof
• Each strategy can be represented as a spectrum
  or continuum:
      Student-centered/teacher-centered
      Problem-based/information-gathering
      Integrated/discipline-based
      Community-based/hospital-based
      Elective/uniform
      Systematic/opportunistic
Educational strategies
• Six educational strategies have been identified in
  relation to curriculum in medical schools by Prof
• Each strategy can be represented as a spectrum
  or continuum:
      Student-centered/teacher-centered
      Problem-based/information-gathering
      Integrated/discipline-based
      Community-based/hospital-based
      Elective/uniform
      Systematic/opportunistic
SPICES Model of Educational Strategies
 • Student centered                       • Teacher centered
   ▫ “What the student learn rather than what is taught"

• Problem-based                         • Information-oriented

• Integrated or Inter-professional      • Subject or Discipline-based
  Integration throughout the curriculum

• Community-based                      • Hospital-based
  Less emphasis on hospital-based
SPICES Model of Educational Strategies

• Elective-driven                             • Uniform
According to student needs
learning & teaching adjusted to the needs
   of students

• Systematic
                                            • Opportunistic
Think, Pair & Share:
What is Integration??
Abraham Flexner Recommendations:
• Under Flexner’s influence, medical curricula
  around the world came to be structured into:
• Preclinical medicine: learned in lecture
  theatres, teaching laboratories, dissecting
  rooms, and libraries
• Clinical medicine: learned in wards and
  operating theatres of university tertiary hospitals
• In the late twentieth century,
  national bodies began to respond to
  the wind of change to meet patients’
  needs to be achieved through
  curriculum integration.
• Disciplines should integrate their
  contributions into a thematic,
  probably systems-based curriculum
• Integration was one of the key
  criteria for assessing the degree of
  innovation in a medical curriculum
  in the SPICES curriculum model
  (Harden, 1984).
                Old Curriculum
Basic Sciences:
    •Medicine, surgery, Ob/Gyn, Peadiatrics,
Learn like doctor & think like doctor
…because human beings are complex
organisms whose discrete systems are
linked intricately and elaborately within
the body and modified profoundly by
external influences, we need to teach in
ways that reflect this complexity and that
stimulate students to synthesize information
across disciplines.

Learn like doctor & think like doctor
A sick patient does not represent a biochemistry
problem, an anatomy problem, a genetics
problem, or an immunology problem; rather,
each person is the product of myriad molecular,
cellular, genetic, environmental, and social
influences that interact in complex ways to
determine health and disease.

What is
Integration: a definition

 “ The teaching of different subject areas
 in a thematic manner, so that the
 different disciplines are not emphasized”

                        al dictionary of Adult & CME
Integration: a definition

 “ The organization of teaching of matter
 to interrelate or unify subjects frequently
 taught in separate academic courses or

                The rationale
• Curriculum organization denotes a systematic
  arrangement of curriculum elements,
• It will results in a more relevant, meaningful, and
  student centered curriculum,
• Integration makes the learning contexts close in
  which the information is to be retrieved.
Think, Pair & Share:
1. Matching curriculum aims.

2. Achieving higher level of objectives.

3. Avoiding information overload.
4. Making learning interesting &
5. Motivating students.

1. Loosing subject identity.

2. Requiring interdepartmental
3. Resources shortage.
       Types of

                    Basic Science


Learning take place better if it is contextual.

Overcrowding information could be solved by

Integration is the necessity & not the luxury.

This is the relatively new trend which has been
applied in med education every where.
I wish you a very
successful and enjoyable
time in your course

      All the

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