Anatomy as the backbone of an integrated first year medical curriculum: Design and implementation

Abstract

Morehouse School of Medicine chose to restructure its first year medical curriculum in 2005. The anatomy faculty had prior experience in integrating courses, stemming from the successful integration of individual anatomical sciences courses into a single course called Human Morphology. The integration process was expanded to include the other first year basic science courses (Biochemistry, Physiology, and Neurobiology) as we progressed toward an integrated curriculum. A team, consisting of the course directors, a curriculum coordinator and the Associate Dean for Educational and Faculty Affairs, was assembled to build the new curriculum. For the initial phase, the original course titles were retained but the lecture order was reorganized around the Human Morphology topic sequence. The material from all four courses was organized into four sequential units. Other curricular changes included placing laboratories and lectures more consistently in the daily routine, reducing lecture time from 120 to 90 minute blocks, eliminating unnecessary duplication of content, and increasing the amount of independent study time. Examinations were constructed to include questions from all courses on a single test, reducing the number of examination days in each block from three to one. The entire restructuring process took two years to complete, and the revised curriculum was implemented for the students entering in 2007. The outcomes of the restructured curriculum include a reduction in the number of contact hours by 28%, higher or equivalent subject examination average scores, enhanced student satisfaction, and a first year curriculum team better prepared to move forward with future integration.

The integrated curriculum in medical education: AMEE Guide No. 96

“…Integrating once separate courses or clinical experiences into a single unit, including combining basic science courses (Schwartz et al 1999;Klement et al 2011), preclinical or clinical preparatory education (Drybye et al 2011), or clinical education (Ogur et al 2007). …”

Integration of Histology Lectures and Practical Teaching in China

“…The young clinical doctors, who undertake intensive work in hospitals, have to continue studies to satisfy the numerous demands in clinical setting. Some reasons account for these problems, such as the medical technology advances, emergence of new diseases, and extension of related medical knowledge (Klement et al, 2011) . However, the effectiveness of the traditional medical teaching system has also been questioned, whether it is adapted well to the current needs of modern medicine, and the current requirements in interdisciplinary pre-clinical and clinical practice (Custers & Cate, 2002) .Traditionally, most of medical educational approaches include didactic lectures given in the classrooms and followed by laboratory or clinical practical days after, where students are expected to verify and master the theoretical knowledge.…”

“…As a backbone of medical science, anatomy is generally integrated into the clinical relevant normal human biology. The anatomical curricular changes in the integrated course include placing laboratories and lectures more consistently, decreasing didactic lectures, eliminating unnecessary duplication of content, and increasing students engagement of self-regulated learning time (Hoffmann & Swailes, 2014;Jonassen et al, 2016;Klement et al, 2011) . Integrated medical courses have been gradually accepted by many medical schools, because they appear to improve student learning attitude and satisfaction in comparison with traditional forms of learning.…”

Differences in the Students’ Perceptions on the Teaching of Neuroanatomy in a Medical Curriculum Organized by Disciplines and an Integrated Medical Curriculum

“…While the introduction of a new system-based course in anatomy was reported by some authors as having a negative impact on the medical students' knowledge, 20 others have found that an integrated curriculum for the first year of medical school for morphology, biochemistry, physiology, and neurobiology, resulted in higher or equivalent subject examination scores. 21 Our study showed that the implementation of a new curriculum is a difficult task, and that the changes that are being made in education in general and in the teaching of neuroanatomy, in particular, should be critically evaluated and fully debated within the medical community. Although Bologna provided us with some guidelines, how to design the best neuroanatomy course is a question with no standard answer and one that is affected by the resources available in different medical schools.…”