Roadblocks to Integration; Faculty's perspective on transition from Traditional to Integrated Medical Curriculum

Undergraduate Medical Education Curriculum Reforms in Pakistan: A Mixed Methods Study of Academic Leadership Perspectives

PURPOSE

Periodic revision of undergraduate medical education (UGME) curricula is an essential part of evidence-based educational practices. Pakistan's national UGME curriculum, last updated in 2005, was reviewed, and recommended updates were made in 2022. The authors explore academic medical school leaders' perspectives about the proposed reforms, gaps within the existing curriculum, and how to ensure the reform implementation is effective, collaborative, and feedback-driven.

METHOD

Using a mixed methods approach, data were collected from April to July 2022. Academic leadership (principals, who could designate vice principals or medical educators) at all medical schools across Pakistan (n = 117) were invited. Agreement with each of 20 proposed reforms was measured via a survey employing a Likert scale. A semistructured interview guide expanded on the survey questions with probes.

RESULTS

Eighty-eight survey responses, from private (59; 67.0%) and public (29; 33.0%) institutions, were obtained (75.2% response rate). Participants recommended most of the proposed reforms. The 3 reforms that received the highest agreement were teaching professionalism as an integral part of the curriculum (83; 94.3%), mandating bedside procedural skills training (80; 90.9%), and including patient safety in the UGME curriculum (79; 89.8%). Including multidisciplinary tumor boards and surgical oncology had the lowest agreement (26; 29.5%). Fifteen interviews were conducted, which revealed 3 major themes: perceptions about changes to the curricular content, limitation of human and financial resources as barriers to reform implementation, and recommendations for effective implementation of an updated curriculum.

CONCLUSIONS

The findings reflect an overall positive attitude of academic medical school leadership toward the 20 proposed UGME curriculum reforms, which could aid with on-the-ground implementation. However, major limitations, such as a lack of trained faculty and financial resources, must be addressed. The authors propose future research on the resources required for implementing UGME reforms and the reforms' impact after national implementation.

Dimensions of challenges in transformation from traditional to integrated modular curriculum - Experiences from Pakistan

Objective

The scarcity of successful implementation of integrated modular curriculum in Pakistan created a lack of evidence-based insight into the process of curriculum transformation. We explored the issue by exploring challenges faced by faculty in implementing integrated modular curriculum.

Methods

An exploratory qualitative study was conducted in 2019-2020, data collected from November 2019 to August 2020, at undergraduate medical colleges in Lahore and Rawalpindi, with semi-structured online interviews of well experienced 11 faculty members. Two levels of faculty were sampled; one completed a successful implementation in two medical colleges, and another in transition process. Transcribed interviews were analyzed on Atlas.ti software.

Results

Challenges were identified in five inter-connected dimensions: integrated modular curriculum (IMC) development, implementation, faculty transformation/change, institutional and regulatory body context.

Conclusion

The curricular shift precipitates demoralizing challenges at multiple levels & directions. The identified themes and connections provide the framework for a well-informed curricular shift.