Academic journal article American Journal of Pharmaceutical Education

Curricular Integration in Pharmacy Education

Academic journal article American Journal of Pharmaceutical Education

Curricular Integration in Pharmacy Education

Article excerpt

When we put together a jigsaw puzzle, we usually have a picture to guide us. None of the pieces means anything taken alone; only when the pieces are put together do they mean something.... This jigsaw puzzle metaphor ought to say something to educators. It is, after all, not unlike how young people experience the curriculum in too many schools. They move from one classroom to another, from one time block to another, from one textbook to another, from one teacher to another, confronted by disconnected, fragmented pieces ofinformation or skills. For these young people, the curriculum is a pile of jigsaw puzzle pieces without a picture.

--James A. Beane, Toward a Coherent Curriculum (1)

INTRODUCTION

Increased attention is being paid to curricular integration in pharmacy education reform. (2,3) Integration is seen as a strategy for making educational experiences coherent, relevant, and engaging; connecting diverse disciplines; and facilitating higher-order learning. Problems and situations that arise in pharmacy practice rarely fall neatly into the disciplinary categories traditionally used to structure pharmacy curricula. If the main purposes of pharmacy education are to provide students with the competencies to function within a large, complex healthcare system and to manage patients' drug therapies for myriad medical conditions, then curricula that integrate disciplines and theory with practice would be beneficial. (4,5) Also, curricular integration is explicitly called for in the accreditation standards for pharmacy programs in both the United States (Accreditation Council for Pharmacy Education Standard 10) and Canada (Canadian Council for Accreditation of Pharmacy Programs Standard 9). (6,7)

Integrative learning has long been the goal of educational programs; however, the responsibility for accomplishing it is shifting from students being expected to make their own connections between coursework in different disciplines and between their classroom and real-life experiences, to instructors and institutions being responsible for designing curricula that will support integrative learning. (8-11) Concerns with curricular integration are driven in part by recognition that integrative learning needs to be fostered to occur for most students, and is hampered by institutional factors such as the proliferation of courses and programs, the diversity of the student population, and the emergence of specialized disciplines. (12-15) However, curricular integration is not a panacea for pharmacy students' fragmented educational experiences or lack of preparedness for practice. There is a danger of integration for integration's sake rather than for sound educational purposes. (16,17) There are gains and losses, and barriers that must be overcome in designing and implementing integrated curricula.

The purpose of this paper is to examine the nature and purpose of curricular integration, strategies for and obstacles to curricular integration, and existing and proposed avenues of scholarly inquiry in curricular integration. This paper draws upon insights gleaned from curriculum design and research experiences in the entry-to-practice program of the Faculty of Pharmaceutical Sciences at the University of British Columbia in Vancouver, Canada.

DEFINING CURRICULAR INTEGRATION

Many consider the terms integration and interdisciplinarity synonymous and do not distinguish among multidisciplinary, interdisciplinary, and transdisciplinary approaches to curriculum design. (9) Different definitions for curricular integration have been suggested, but one that is well-suited to pharmacy curricula is the "intentional uniting or meshing of discrete elements or features [of a planned educational experience]." (18) Another distinction that is not always made is that between integrated and integrative curricula, the former referring to educational experiences designed to demonstrate to students the patterns and applications of different knowledge domains, and the latter referring to curricula in which students create their own patterns. …

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