Discipline Based Versus Integrated Curricula: A Comparative Study between Clinical II Medical Students of Adama Hospital Medical College and Adigrat University, Ethiopia With Regards to Retaining Knowledge of Basic Sciences and Ability to Use Their Concepts and Principles to Solve Clinical Problems
Creators: name: Redwan, Ekram
Publisher: name: National Academic Digital Repository of Ethiopia
Year: 2016

description: Background: In Ethiopia, the discipline based curriculum, has been implemented since medicine program started in the country. This curriculum model is still in use by 20 of the 35 medical schools in the country. However, the curriculum has been criticized for not helping students retain the knowledge they acquired in pre-clinical years and apply it in their clinical practice. Objective: To compare the performance of those students who pass through integrated curriculum with those who pass through discipline based curriculum in terms of retention of basic science knowledge and application of principles and concepts Method: A comparative cross-sectional study was conducted between medical students of Adama hospital medical college (AHMC) and Adigrat University (AU), school of medicine in August 2016. A standardized MCQ exam that tested students" ability of recall and application of knowledge was administered to clinical II students of the two medical schools. Test mean scores were compared. Results: A total of 99 examinees participated of which 65 of them were from AHMC and 34 from AU. The mean score of the exam is 53.7 (SD=10.051) where the mean for part II (Application questions) is higher which is 58.1 where as for part I (recall questions), it is 49.4. The higher score was on pharmacology with mean value of 61.3 followed by biochemistry, 59.4. The mean scores of the exam in both schools are almost similar which are 54 in AHMC and 53 in AU. The percentage of students who scored more than 60% (The pass mark) is higher in AU accounting for 41.2% and 33.8% in AHMC. Higher number of students in AU scored above 60% on part I accounting for 20.5% where as it is 13.8% in AHMC. However, the percentage of students who scored above 60% on part II is similar in both AHMC and AU accounting for 50.8% and 50% respectively. Final score hasn"t shown statistically significant difference in sex (p=0.063, x2= 3.454).Similar finding was found while separately performing the test for each school (p=0.116, x2=2.474 for AHMC, p=0.288, x2=1.13 for AU).Similarly, it hasn"t shown statistically significant difference in age group (p=0.472, x2= 0.518). 3 The binary logistic regression showed that the final score of the exam is not significantly associated with the type of curriculum (p=0.472). Conclusion and Recommendation: The mean test score in both medical schools is not satisfactory showing performance in high stake context dependent application exam is challenging. This can be attributed to either limited experience of the students to this type of examination or drawback in content delivery which has focused in teaching recall of isolated facts than application of knowledge to solve clinical problems. The result of this study didn"t show significant difference between medical students from the discipline based and integrated curriculum in terms of retaining basic science knowledge and using concepts and principles to solve clinical problems. Hence, since there are many confounding factors which could affect students" performance; it"s difficult to generalize the findings. It"s therefore important to further investigate the effects including the implementation of integrated curriculum.