Extending the theoretical framework for curriculum integration in pre-clinical medical education

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.