摘要：Vertical integration is believed to increase motivation by providing context for the learning. In this
quasi-experimental study, cohort I took two horizontally integrated
modules: structure and function of head, neck, and special senses in
the second year, and pathophysiology and clinical sciences in the third
year. Cohort II took a combined, vertically integrated module in the
second year. Data from the questionnaire and examination scores were
compared. Response rate was 80.1% (125/156) for cohort I and 57.6%
(98/170) for cohort II. Response to the statement that vertical integration provides context to basic sciences was mixed with a higher
agreement in cohort II (51.5 vs. 37.2%; P 0.04). Cohort II was least
satisfied with the appropriateness of self-study time (52.0 vs. 34.7%;
P 0.01). However, cohort II felt that the basic sciences lectures
(90.8 vs. 69.4%; P 0.01) and the clinical skills sessions (85.7 vs.
62.1%; P 0.01) were more effective. Cohort II was less satisfied
with clinical lectures (80.6 vs. 56.1%; P 0.01) and was less
confident in achieving clinical learning objectives (72.8 vs. 40.8%;
P 0.01). Mean multiple-choice questions and problem-based learning scores were similar. However, the short-answer question score
was higher for cohort I [82.48 (SD 14.9) vs. 70.74 (SD 17.9); P
0.01]. Overall, the idea of early vertical integration had a mixed
response. It improved the effectiveness of basic sciences lectures and
clinical skills sessions. Achievement of clinical learning outcomes
was compromised. A disparity in the module’s duration and curricular
content, and students’ ability to grasp clinical concepts and faculty’s
expectations are the possible reasons. Increased duration and better
communication with clinical faculty may improve early introduction
of vertical integration.
关键词：clinical sciences; medical curriculum; undergraduate; vertical integration
