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Year : 2019  |  Volume : 12  |  Issue : 1  |  Page : 93-94  

Critiquing the component of integrated teaching proposed under the new graduate medical regulations 2018

Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India

Date of Web Publication22-Jan-2019

Correspondence Address:
Saurabh Rambiharilal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, 3rd Floor, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjdrdypu.mjdrdypu_229_18

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How to cite this article:
Shrivastava SR, Shrivastava PS. Critiquing the component of integrated teaching proposed under the new graduate medical regulations 2018. Med J DY Patil Vidyapeeth 2019;12:93-4

How to cite this URL:
Shrivastava SR, Shrivastava PS. Critiquing the component of integrated teaching proposed under the new graduate medical regulations 2018. Med J DY Patil Vidyapeeth [serial online] 2019 [cited 2022 Sep 29];12:93-4. Available from: https://www.mjdrdypv.org/text.asp?2019/12/1/93/250434

Dear Sir,

The much-awaited undergraduate medical curriculum in India has been finally revised after close to two decades by the Medical Council of India in order to meet the changing health needs of the nation.[1] All the modifications which have been proposed are done keeping the ultimate goal of producing an Indian medical graduate at the end of the course, who is competent enough to act as a primary care physician and be globally relevant.[1],[2] To accomplish this goal, students have to be trained through appropriate teaching–learning strategies and subsequently assessed adequately to measure their progress of learning.[1],[2]

Acknowledging the fact that in the existing curriculum, the knowledge about the subjects was imparted in a fragmented manner, it has been advocated to promote integration, so that the students are able to establish links between different subjects and understand the topic in a more comprehensive manner which will be useful for them in their future clinical practice.[1],[3] However, it has been recommended to continue with the strengths of the existing teaching–learning and assessment pattern but definitely exposes the students to integrated learning to improve their understanding.[1]

The document advocates for integration up to the level of temporal coordination (viz. common topics across various specialties can be taught separately but within a common time span), which is the level 5 in the integration ladder proposed for the development of integrated curriculum.[1],[4] This suggests that despite realizing the need of integrated teaching in the undergraduate teaching program, the integration should not go beyond level 5, as it becomes difficult for the students to comprehend the topic and necessitates extensive planning by the involved departments.

A maximum integration of 20% has been recommended in the course, which gives a clear-cut guideline for the curriculum committee members to plan an integrated learning within the permissible limits.[1] Case-based discussion has been preferred as the best approach for integrated sessions.[1] This could be expanded further by including sessions on problem-oriented learning, as that will help the learners to develop critical thinking, clinical reasoning, and problem-solving skills. However, it would have been better to either provide the checklist for the assessment of these integrated sessions or at least the broad guidelines under which the effectiveness of integrated sessions (especially in terms of students' learning and also in terms of execution) can be assessed.

It has been recommended to define specific learning objectives (SLOs) for the integrated session before conducting the session, which is very much true, as it will help us to measure whether we were successful in meeting the set objectives.[1] Under ideal circumstances, all the involved departments should sit together and systematically plan SLOs to make it more effective for the learners. Moving further, emphasis has been given that integration does not mean that in a single session, teachers from different specialties should come for teaching (unless it is very much essential), instead the best thing is to involve them in the lesson planning stage.[1] It is a very valid point, as considering the clinicians have to manage hospital work as well, if we involve them in each session in class, very soon they might lose interest and will reduce their participation, and thus, the sustainability of integrated teaching becomes questionable.

Further, it has been clearly voiced that the topics which cannot be integrated should be taught separately and that too throughout the year, instead of cramping everything in one specific semester.[1] Finally, pertaining to assessment, it has been proposed to continue with subject-wise assessment but at the same time ensures that learning pertaining to integrated concepts and internalization among learners is assessed.[1] This is little ambiguous, as one of the basic principles of assessment is to ensure that teaching–learning activities should be in alignment with assessment. However, if we want to assess subject-wise only, then there is no need for introducing the integrated teaching. The best approach will be to introduce an integrated form of assessment as a part of formative assessments and a suitable checklist should be developed to measure the extent of learning.

In conclusion, the newly proposed graduate medical regulation 2018 gives a clear stand regarding the status of integrated teaching in the undergraduation period, nevertheless still some clarifications need to be given for the assessment of integrated learning.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Medical Council of India. Competency Based Under Graduate Curriculum; 2018. Available from: https://www.old.mciindia.org/InformationDesk/ForColleges/UGCurriculum.aspx. [Last accessed on 2018 Nov 10].  Back to cited text no. 1
Chacko TV. Moving toward competency-based education: Challenges and the way forward. Arch Med Health Sci 2014;2:247-53.  Back to cited text no. 2
  [Full text]  
Haranath PS. Integrated teaching in medicine – Indian scene. Indian J Pharmacol 2013;45:1-3.  Back to cited text no. 3
[PUBMED]  [Full text]  
Harden RM. The integration ladder: A tool for curriculum planning and evaluation. Med Educ 2000;34:551-7.  Back to cited text no. 4


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