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Kerr A, O'Connor H, Pawlikowska T, Gallagher P, Strawbridge J. A scoping review of health professional curricula: Implications for developing integration in pharmacy. Res Social Adm Pharm 2019; 16:1-16. [PMID: 30898572 DOI: 10.1016/j.sapharm.2019.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 03/08/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Integrated health professions curricula aim to produce graduates who are capable of meeting current and future healthcare needs. This is reflected in pharmacy education where integration is increasingly advocated by pharmacy regulators as the perceived optimal way of preparing students for registration as pharmacists. There is, however, no definition of integration. Integration can be described according to a model of horizontal, vertical or spiral integration. It can also be described by the themes used to integrate, such as a systems-based approach or by integrative teaching and learning approaches. The level of integration can also be described. OBJECTIVE This scoping review aimed to explore health professions education literature to inform the optimal design of integrated pharmacy curricula. This review asks: what is meant by integration in health professions curricula? METHODS The Arksey and O'Malley scoping review framework was utilised. Ovid MEDLINE, EMBASE, Scopus, Web of Science and ERIC were searched. Models of integration, themes for integration, integrative teaching and learning approaches, and level of integration were defined and supported data extraction. RESULTS There were 9696 records screened and of these 137 were included. The majority of studies (n = 88) described horizontal integration. Systems-based teaching (n = 56) was the most common theme reported. Various integrative teaching and learning approaches were described, including experiential (n = 43), case-based (n = 42) and problem-based (n = 38) learning. The majority of the curricula could be classified as levels 5-7 on Harden's ladder (n = 102). Perception outcomes were reported for 81 studies, and only 3 reported outcomes beyond perception. Reported outcomes were generally positive and included knowledge gains and increased motivation. CONCLUSIONS There is a need for integration to be explicitly defined by curriculum developers and researchers. Attention should be given to describing the model, theme, teaching and learning approach and level of integration. There remains a lack of evidence for integration.
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Affiliation(s)
- Aisling Kerr
- RCSI School of Pharmacy, 1st Floor Ardilaun House Block B, 111 St Stephen's Green, Dublin 2, Ireland.
| | - Hannah O'Connor
- RCSI School of Pharmacy, 1st Floor Ardilaun House Block B, 111 St Stephen's Green, Dublin 2, Ireland.
| | - Teresa Pawlikowska
- RCSI Health Professions Education Centre, 123 St Stephen's Green, Dublin 2, Ireland.
| | - Paul Gallagher
- Department of Pharmacy, 18 Science Drive 4, National University of Singapore, 117559, Singapore.
| | - Judith Strawbridge
- RCSI School of Pharmacy, 1st Floor Ardilaun House Block B, 111 St Stephen's Green, Dublin 2, Ireland.
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Mauldin Pereira M, Artemiou E, McGonigle D, Conan A, Sithole F, Yvorchuk-St Jean K. Using the Virtual World of Second Life in Veterinary Medicine: Student and Faculty Perceptions. JOURNAL OF VETERINARY MEDICAL EDUCATION 2018; 45:148-155. [PMID: 28885871 DOI: 10.3138/jvme.1115-184r4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Virtual worlds are emerging technologies that can enhance student learning by encouraging active participation through simulation in immersive environments. At Ross University School of Veterinary Medicine (RUSVM), the virtual world of Second Life was piloted as an educational platform for first-semester students to practice clinical reasoning in a simulated veterinary clinical setting. Under the supervision of one facilitator, four groups of nine students met three times to process a clinical case using Second Life. In addition, three groups of four clinical faculty observed one Second Life meeting. Questionnaires using a 4-point Likert scale (1=strongly disagree to 4=strongly agree) and open-ended questions were used to assess student and clinical faculty perceptions of the Second Life platform. Perception scores of students (M=2.7, SD=0.7) and clinical faculty (M=2.7, SD=0.5) indicate that Second Life provides authentic and realistic learning experiences. In fact, students (M=3.4, SD=0.6) and clinical faculty (M=2.9, SD=1.0) indicate that Second Life should be offered to future students. Moreover, content analyses of open-ended responses from students and faculty support the use of Second Life based on reported advantages indicating that Second Life offers a novel and effective instructional method. Ultimately, results indicate that students and clinical faculty had positive educational experiences using Second Life, suggesting the need for further investigation into its application within the curriculum.
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Affiliation(s)
- Mary Mauldin Pereira
- Ross University School of Veterinary Medicine, P.O. Box 334, Basseterre, St. Kitts, West Indies.
| | - Elpida Artemiou
- Ross University School of Veterinary Medicine, P.O. Box 334, Basseterre, St. Kitts, West Indies
| | - Dee McGonigle
- Chamberlain College of Nursing, 3005 Highland Parkway, Downers Grove, IL 60515 USA
| | - Anne Conan
- Ross University School of Veterinary Medicine, P.O. Box 334, Basseterre, St. Kitts, West Indies
| | - Fortune Sithole
- Ross University School of Veterinary Medicine, P.O. Box 334, Basseterre, St. Kitts, West Indies
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Laksov KB, McGrath C, Josephson A. Let's talk about integration: a study of students' understandings of integration. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2014; 19:709-720. [PMID: 24604665 DOI: 10.1007/s10459-014-9499-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 02/24/2014] [Indexed: 06/03/2023]
Abstract
Today, the knowledge concerning clinical reasoning is advanced enough to translate into curriculum interventions such as an integrated curriculum, in which science theory and clinical practice can be interwoven effectively. However, the interpretations of what integration means differ and the purpose of this study was to elicit how students understand integration. This study was carried out using an interpretative perspective. Medical students, in their 2nd year of study, were asked to apply basic science knowledge from all previous courses to clinical cases in an examination. Subsequent to the examination, focus group interviews were conducted. The interviews were audio recorded, transcribed and analysed by the use of qualitative content analysis. The analysis revealed how students comprehended integration: as the creation of wholeness, as relating new knowledge to core concepts, as reasoning, as application and as collaboration between teachers. The five categories were linked to three dimensions: intra-personal, inter-personal and organizational, each of which resonates with different theories of how expertise is developed. The outcome of this study adds to our understanding of how students conceptualize integration. The categories of 'integration' drawn out by the study are helpful in promoting further discussion of how eliciting students' own reports of cognition and may help the ongoing design of curricula by putting students at the center of the curriculum design process.
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Affiliation(s)
- Klara Bolander Laksov
- Unit of Medical Education, Department of Learning, Instruction, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden,
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Oda Y, Onishi H, Sakemi T, Fujimoto K, Koizumi S. Improvement in medical students' communication and interpersonal skills as evaluated by patient satisfaction questionnaire after curriculum reform. J Clin Biochem Nutr 2014; 55:72-7. [PMID: 25120283 PMCID: PMC4078071 DOI: 10.3164/jcbn.14-29] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 02/27/2014] [Indexed: 11/23/2022] Open
Abstract
Fifteen years of undergraduate medical education curriculum reform at Saga Medical School was evaluated by measuring medical students’ communication and interpersonal skills with a patient satisfaction questionnaire developed by the American Board of Internal Medicine. A multiphase cross-sectional study was conducted at the General Medicine Clinic of Saga Medical School Hospital in phase I (1998–1999), phase II (2001–2002), and phase III (2009–2010). A total of 1,963 patient ratings for 437 medical students’ performance was analyzed. The average scores of phases II and III were significantly higher than for phase I. The average score of female students showed a significant difference between phases I and II, but no difference between phases II and III. The average score of male students showed no difference between phases I and II, but significant difference between phases II and III. The phase II curriculum introduced basic clinical skills and examination and improved female students’ performance. The phase III curriculum was effective for male students because it emphasized the clinical skill program more and introduced problem-based learning. Curriculum reform at Saga Medical School is considered to have made good progress in improving students’ clinical competence and patient-centered attitudes.
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Affiliation(s)
- Yasutomo Oda
- Center for Comprehensive Community Medicine, Saga Medical School, 5-1-1 Nabeshima, Saga 845-8501, Japan
| | - Hirotaka Onishi
- International Research Center for Medical Education, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Takanobu Sakemi
- Center for Comprehensive Community Medicine, Saga Medical School, 5-1-1 Nabeshima, Saga 845-8501, Japan
| | - Kazuma Fujimoto
- Dean of Faculty of Medicine, Saga Medical School, 5-1-1 Nabeshima, Saga 845-8501, Japan
| | - Shunzo Koizumi
- Professor Emeritus, Saga Medical School, 5-1-1 Nabeshima, Saga 845-8501, Japan ; Director, Shichijo Clinic, 29 Sujakukitanokuchi-cho, Shimogyo-ku, Kyoto 600-8845, Japan
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Blanchard S, Glasgow P. A theoretical model to describe progressions and regressions for exercise rehabilitation. Phys Ther Sport 2014; 15:131-5. [PMID: 24913914 DOI: 10.1016/j.ptsp.2014.05.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 05/08/2014] [Accepted: 05/09/2014] [Indexed: 11/27/2022]
Abstract
This article aims to describe a new theoretical model to simplify and aid visualisation of the clinical reasoning process involved in progressing a single exercise. Exercise prescription is a core skill for physiotherapists but is an area that is lacking in theoretical models to assist clinicians when designing exercise programs to aid rehabilitation from injury. Historical models of periodization and motor learning theories lack any visual aids to assist clinicians. The concept of the proposed model is that new stimuli can be added or exchanged with other stimuli, either intrinsic or extrinsic to the participant, in order to gradually progress an exercise whilst remaining safe and effective. The proposed model maintains the core skills of physiotherapists by assisting clinical reasoning skills, exercise prescription and goal setting. It is not limited to any one pathology or rehabilitation setting and can adapted by any level of skilled clinician.
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Affiliation(s)
- Sam Blanchard
- Brighton & Hove Albion Football Club, American Express Stadium, Village Way, Falmer, East Sussex BN1 9PL, United Kingdom.
| | - Phil Glasgow
- Sports Institute of Northern Ireland, University of Ulster, Newtownabbey, Co. Antrim BT37 0QB, United Kingdom
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Callis AN, McCann AL, Schneiderman ED, Babler WJ, Lacy ES, Hale DS. Application of Basic Science to Clinical Problems: Traditional vs. Hybrid Problem-Based Learning. J Dent Educ 2010. [DOI: 10.1002/j.0022-0337.2010.74.10.tb04966.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Amber N. Callis
- University of Texas Health Science; Center at Houston Dental Branch
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Abstract
RATIONALE, AIMS AND OBJECTIVES Diagnostic reasoning and treatment decisions are a key competence of doctors. A model based on values and probability provides a conceptual framework for clinical judgments and decisions, and also facilitates the integration of clinical and biomedical knowledge into a diagnostic decision. METHOD Both value and probability are usually estimated values in clinical decision making. Therefore, model assumptions and parameter estimates should be continually assessed against data, and models should be revised accordingly. Introducing parameter estimates for both value and probability, which usually pertain in clinical work, gives the model labelled subjective expected utility. Estimated values and probabilities are involved sequentially for every step in the decision-making process. RESULTS Introducing decision-analytic modelling gives a more complete picture of variables that influence the decisions carried out by the doctor and the patient. CONCLUSION A model revised for perceived values and probabilities by both the doctor and the patient could be used as a tool for engaging in a mutual and shared decision-making process in clinical work.
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Affiliation(s)
- Monica Ortendahl
- Department for Security Research, Royal Institute of Technology, Stockholm, Sweden.
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Kingsley K, O'Malley S, Stewart T, Galbraith GM. The Integration Seminar: A First-Year Dental Course Integrating Concepts from the Biomedical, Professional, and Clinical Sciences. J Dent Educ 2007. [DOI: 10.1002/j.0022-0337.2007.71.10.tb04396.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Karl Kingsley
- Department of Biomedical Sciences; University of Nevada, Las Vegas, School of Dental Medicine
| | - Susan O'Malley
- Department of Biomedical Sciences; University of Nevada, Las Vegas, School of Dental Medicine
| | - Tanis Stewart
- Department of Information Technology; University of Nevada, Las Vegas, School of Dental Medicine
| | - Gillian M. Galbraith
- Department of Biomedical Sciences; University of Nevada, Las Vegas, School of Dental Medicine
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Hendricson WD, Andrieu SC, Chadwick DG, Chmar JE, Cole JR, George MC, Glickman GN, Glover JF, Goldberg JS, Haden NK, Meyerowitz C, Neumann L, Pyle M, Tedesco LA, Valachovic RW, Weaver RG, Winder RL, Young SK, Kalkwarf KL. Educational Strategies Associated with Development of Problem-Solving, Critical Thinking, and Self-Directed Learning. J Dent Educ 2006. [DOI: 10.1002/j.0022-0337.2006.70.9.tb04163.x] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - William D. Hendricson
- Educational and Faculty Development; University of Texas Health Science Center at San Antonio Dental School
| | | | | | | | | | - Mary C. George
- Department of Dental Ecology; University of North Carolina School of Dentistry
| | | | | | | | | | - Cyril Meyerowitz
- Eastman Dental Center; University of Rochester School of Medicine and Dentistry
| | | | | | | | | | - Richard G. Weaver
- Center for Educational Policy and Research; American Dental Education Association
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