KOJURI J M D CARDIOLOGIST INTERVENTIONIST ASSOCIATE PROFESSOR

KOJURI J. M. D. CARDIOLOGIST INTERVENTIONIST ASSOCIATE PROFESSOR OF SUMS ﻣﺮکﺰﻣﻄﺎﻟﻌﺎﺕ ﻭ ﺗﻮﺳﻌﻪ آﻤﻮﺯﺵ پﺰﺷکی ﺷیﺮﺍﺯ I

Definition n In general, all of the definitions of integrated curriculum or interdisciplinary curriculum include: n n n n 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

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

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

Ladder Kojuri J

Vertical integration of learning objectives Community Need Assessment Role Definition Task Analysis Clinical Educational Need Assessment Educational Goals Basic Science Educational Need Assessment Instructional Objectives Kojuri J

Vertical integration of learning objectives Valvular Heart Diseases are Common In Iran Role Definition Task Analysis Clinical Educational Need Assessment Educational Goals Basic Science Educational Need Assessment Instructional Objectives Kojuri J

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, … Educational Goals anatomy and physiology of heart valves, … Instructional Objectives Kojuri J

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

Anatomy Histology Embryology Physiology 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 Internal Medicine Heart Lung Surgery Pediatrics Kojuri J Kidney Nervous System Gynecology Conventional Fragmented Curriculum

Synchronized (Sequenced) Integration An Asynchronized Curriculum Histology Embryology 1 2 3 4 1 2 3 4 Physiology 1 2 3 4 Kidney Nervous System Heart Lung Kojuri J Time Anatomy

Synchronized (Sequenced) Integration A Synchronized Curriculum Histology Embryology Physiology 1 2 3 4 1 2 3 4 Kidney Nervous System Heart Lung Kojuri J Time Anatomy

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

Heart Lung Kidney Nervous System 1 2 3 4 1 2 3 4 Anatomy Histology Embryology Physiology Horizontal Integration In Basic Science Organ System Approach Kojuri J

Horizontal integration of clinical courses n Some schools divide their clerkships into ambulatory clerkships called: n n n 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

Vertical integration n 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

Conventional unintegrated curriculum Basic Science Kojuri J Clinical Science

Vertical distribution of courses Kojuri J

Vertical diffusion of content Basic Science Clinical Kojuri J Science

Vertical diffusion of content Pure anatomy Anatomy with clinical correlations Clinical anatomy Surgery with anatomical correlations Kojuri JPure surgery

Anatomy Histology Embryology Heart 1 2 3 4 Lung Kidney 1 2 3 4 Nervous System 1 2 3 4 1 2 3 4 Physiology and Internal Medicine Anatomy and Surgery Kojuri J vertical integration of basic and clinical science displacement and merging Physiology

Early exposure to clinical settings n A vast majority of schools expose students to real patients in clinical settings in the first two years, the courses having such names as n n n doctoring skills clinical applications of basic science patient-doctor physician and society clinical skills Kojuri J

Spiral curriculum n Content is broken into its smallest Vertical Integration components n Prerequisite of each component is determined n Instruction of basic science content is postponed in curriculum as long as it is possible n Instruction of clinical science components are pushed forward in curriculum as long as it is possible n horizontal integration of contents is performed at each level Horizontal Integration Kojuri J

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

Threaded model of curriculum integration Skill 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 metacurriculum that overlays subject content matter. Kojuri J n

Integration: teacher and setting n Basic science content is thought by a Ph. D teacher in university classroom Ø Clinical science content is thought by a MD teacher in hospital Kojuri J

Integration: teacher and setting n Basic and some clinical science content is thought by a MD-Ph. D teacher in university classroom Kojuri J

Integration: teacher and setting n Kojuri J Basic and some clinical science content is thought by joint MD and Ph. D teams

Integration: teacher and setting Ø clinical and some basic science content is thought by joint MD and Ph. D teams participation of pharmacologists in clinical rounds Kojuri J

Integration: teacher and setting Ø Simply change the setting of basic science teaching to clinical ones Kojuri J

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

Vertical integration in evaluation of educational achievement conventional model Kojuri J of evaluation: an exam after each course

Vertical integration in evaluation of educational achievement or a single exam at the end of basic science courses Kojuri J

Vertical integration in evaluation of educational achievement vertical integration by delaying basic science exam Kojuri J

Integration Through Central Governance of Curriculum Fragmented curriculum, departments, and governance Kojuri J

Integration Through Central Governance of Curriculum Committee central governance on different departments Kojuri J

Integration Through Central Governance of Curriculum Committee Interdisciplinary Departments Central governance on teams, build by removing the Kojuri J walls between departments

Integration Through Central Governance of Curriculum Committee Interdisciplinary Departments Integrated Curriculum Central governance on integrated teams who deliver Kojuri J curriculum an integrated

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

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

Vision impossible Kojuri J

Phase II Malcom Skilbek Situational analysis Kojuri J

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

Phase IV Evaluation Kojuri J

Situation war! Kojuri J

Phase V n Going toward vertical integration: 1) Teacher coordination 2) Inserting clinical science to basic science 3) Early clinical exposure 4) Curriculum overload Kojuri J

Foggy situation Kojuri J