Most curricula for medical education have been integrated horizontally and vertically–-vertically between basic and clinical sciences. The Flexnerian curriculum has disappeared to permit integration between basic sciences and clinical sciences, which are taught throughout the curriculum. We have proposed a different form of integration where the horizontal axis represents the defined learning outcomes and the vertical axis represents the teaching of the sciences throughout the courses. We believe that a mere integration of basic and clinical sciences is not enough because it is necessary to emphasize the importance of humanism as well as health population sciences in medicine. It is necessary to integrate basic and clinical sciences, humanism, and health population in the vertical axis, not only in the early years but also throughout the curriculum, presupposing the use of active teaching methods based on problems or cases in small groups.

The relationship between students’ withdrawal and educational variables has generated a considerable number of publications. As the explosion of information in sciences and integration theories led to creating different curriculum designs, it has been assumed that differences among designs explain academic success and, therefore, students’ retention. However, little attention has been given to examine explicitly how diverse designs influence dropout rates in practice, which questions if decisions to reform curricula are sufficiently informed. This article describes our curriculum reform, which exposes our former and current curriculum designs as having had dissimilar dropout percentages. Furthermore, we aimed to explore the influence of different curriculum designs on students’ dropout rates. The conclusion is that dropout variations may be explained not only because of the curriculum design itself, but also because of the power relationship changes between teachers and students that brought out the design change. Consequently, more research is needed to fully understand the political implications of different curriculum designs and their influence on dropout rates.

Introduction Curriculum integration is widely discussed in medical education but remains ill defined. Although there is plenty of information on logistical aspects of curriculum integration, little attention has been paid to the contextual issues that emerge from its practice and may complicate students' knowledge integration. Therefore, we aimed to uncover how curriculum integration is manifested through context. Methods We collected data from the official curriculum and interviewed ten participants (including curriculum designers, facilitators, and students) in the bachelor's medical program at Aalborg University. We observed various learning activities focused on pre-clinical education. Inspired by grounded theory, we analyzed the information we gathered. Results The following theoretical constructs emerged after the inductive analysis: 1) curriculum integration complexity is embedded in the institutional learning perspectives; 2) curriculum integration is used to harmonize conflicting learning perspectives in curriculum practice; 3) curriculum integration creates tensions that self-organize its structure; and 4) curriculum integration becomes visible in collaborative learning spaces. Discussion These constructs provide a framework for analyzing curriculum integration in the context in which it is meant to appear, which may assist educationalists to gain a more specific understanding of the term. This may enable effective curriculum integration since contextual issues are addressed in addition to the goals specified in the official curriculum. Keywords Curriculum design · Curriculum integration · Problem-based learning · Grounded theory · Medical education What this paper addsCurriculum integration is considered of key importance for reforming medical programs across the world, yet many medical schools struggle with integrating their curricula. This is possibly a consequence of the confusion derived from diverse definitions of curriculum integration anchored in multiple learning theories. Moreover, the existing definitions pay little attention to the contextual issues of medical schools. Approaching curriculum integration through an extended theory that takes into consideration contextual issues may provide medical educators insights into contextually determined conflicts, tensions and learning perspectives influencing the curriculum practice.

The traditional, subject-based medical curriculum in Colombia has been mainly focused on the biomedical model proposed by Flexner in 1910. This means learning outcomes or competences are framed on curative care and the specialization of physicians. Students are mainly trained to work in highly complex hospitals in urban centers and encouraged to enroll (as soon as possible) in residencies. This curriculum lacks pertinence to implement the new Colombian Primary Health Care Model as the focus is a shift toward the promotion of health and prevention of illness. Recommendations to provide light on how to implement a change for ensuring pertinence of medical education in this context are discussed.

The magnitude of the injury pattern in femicides by stabbing in Colombian womenLa magnitud del patrón de lesión en los feminicidios con arma cortopunzante en mujeres colombianas | Abstract |Introduction: Assessing the severity of the injuries suffered by victims may contribute to prevent femicide more effectively.Objective: To establish whether the amount of wounds recorded in femicides by stabbing vary according to the age of the victim and the victim-offender relationship. Materials and methods:Cases of Colombian women who were stabbed to death between 2011 and 2013 (n=331; age: 14-91 years) were included in the study. They were classified according to age ranges and the type of relationship with the offender. Descriptive analyses were conducted. Two one-way ANOVAs and a factorial ANOVA were performed to assess the differences in the mean number of the stab wounds received by the victim, and to determine the effects of interaction among the established categories. Results:The pattern of injury severity was higher in women aged 22 to 40 years than in those aged 41 to 55 years, and in women attacked by their intimate partners than in those attacked by strangers and acquaintances. Age ranges and types of relationship had an interaction effect on the dimension of the sustained wound. Conclusion:The age of the victims and the types of relationship they had with the offender are variables that should be considered to propose preventive policies on femicide since both are correlated to violent acts with greater injury patterns.Keywords: Homicide; Battered women; Public health; Forensic medicine; Wounds and injuries (MeSH).Vergel J, Trompetero-González AC. Objetivo. Determinar si el número de heridas en los feminicidios con arma cortopunzante varía respecto a la edad de la víctima y su relación con el atacante. Materiales y métodos.La población correspondió a mujeres colombianas lesionadas hasta la muerte con arma cortopunzante entre 2011 y 2013 (n=331; edad promedio 14-91 años), quienes fueron categorizadas por rangos de edad y tipos de relación con los agresores. Dos análisis ANOVA de una vía y uno factorial permitieron identificar diferencias entre los promedios de las lesiones de las víctimas y los efectos de interacción entre las categorías establecidas.Resultados. El patrón de gravedad del trauma físico fue mayor en mujeres entre los 22 y 40 años y con vínculos románticos con los agresores. Los rangos de edad y tipos de relación tuvieron efectos de interacción sobre la cantidad de heridas sufridas.Conclusión. La edad de las víctimas y el tipo de relación que tenían con el agresor son variables a considerar al diseñar políticas de prevención del feminicidio dado que su conexión con actos violentos resulta en un patrón peor de lesiones. IntroductionAlthough femicide is recognized as a public health problem around the world (1,2), in Colombia, most studies on this topic have focused on characterizing the victims and describing the violent acts (3-7); however, research directed to assess the relationship between ...