A Systematic Review of Integrated Learning Definitions, Frameworks, and Practices in Recent Health Professions Education Literature

Abstract

International curricular redevelopment and quality improvement efforts include integration within and across disciplines as a focal point. Definitions and applications of the term ‘integration’ vary routinely in health professions education literature, weakening opportunities to enhance our educational practice through collaborative, interprofessional knowledge-sharing. This systematic review examined recent health professions education literature for reported definitions, theories or frameworks, and educational activities around integrated learning, education, curricula, or teaching. A total of 35 articles representing learners from 12 different health professions, between 2017 and 2021, were analyzed through a literature search of seven databases: PubMed, Scopus, CINAHL, JSTOR, the Cochrane Library, LGBTQ + Life, and ERIC. Full-text retrieval and data extraction of the included studies were conducted. Of the 35 articles reviewed, 13 included explicit definitions of integration (an additional six alluded to a definition), 19 referred to an educational theory or framework used to guide integration design efforts, and 27 mentioned teaching methods by which integration was implemented. Misunderstanding what is meant by integrated, how others have planned for it, or how others have sought to bring it about practically, all threaten attempts to improve the cultivation of health professionals as integrated thinkers and holistic care providers.

The moderating effect of knowledge-sharing on learning organisation and quality improvement practices

“…In burn services in Malawi and Ethiopia, in relation to QI initiatives, major enablers included efficacious KS, whereas a negative ethos with respect to training was a main obstacle (Holden et al, 2021). Through a literature review of health professions education, KS was found to be an important factor affecting QI (Matinho et al, 2022). Besides, through empirical studies in the healthcare sector, KS has been found to be a key factor affecting QI interventions (Allen, 2016), QI awareness (Hut-Mossel et al, 2021), QI collaborative (Olsen et al, 2021), continuous QI (Laycock et al, 2018), andQIP (El Morr andJulien, 2010;Sorakraikitikul and Siengthai, 2014;Aveling et al, 2017;Hassanain, 2017;Svenningsson et al, 2019;Lebcir and James, 2021;Nelson et al, 2022).…”

“…In burn services in Malawi and Ethiopia, in relation to QI initiatives, major enablers included efficacious KS, whereas a negative ethos with respect to training was a main obstacle (Holden et al ., 2021). Through a literature review of health professions education, KS was found to be an important factor affecting QI (Matinho et al ., 2022). Besides, through empirical studies in the healthcare sector, KS has been found to be a key factor affecting QI interventions (Allen, 2016), QI awareness (Hut-Mossel et al.…”

“Preparing them for the profession”: An interpretative phenomenological analysis of anatomy educators coping with complexity in the United Kingdom curriculum

“…First, anatomy educators are increasingly expected to learn, deploy, and participate in a dizzying array of innovative teaching activities (Owolabi & Bekele, 2021) as well as engage with curricular practices imposed by their institution, having to do more with considerably less in the way of time and training resources. Matinho et al (2022) report that a total of 43 distinct practices designed to achieve integrated learning, education, curriculum, or teaching were identified in 77% of the articles they reviewed.…”

“…This polar distinction divided the curriculum and stratified the linear timescale used in medical education since the historic 1910 reforms of Abraham Flexner (Flexner, 1910; Duffy, 2011). Curriculum research over the last several decades has been aiming for integration, despite the routine variation of applications and definitions of the term as pointed out by Matinho et al (2022) in their recent systematic review of integrated learning definitions. Without unified definitions, the term ‘integration’ has become more of a buzzword (Brauer & Ferguson, 2015).…”

A systematic scoping review of reflective writing in medical education

“…Perhaps the most common form of reflective practice in medical education is reflective writing (RW) [ 25 ]. Identified as one of the distinct approaches used to achieve integrated learning, education, curriculum and teaching [ 26 ], RW already occupies a central role in guiding and supporting longitudinal professional development [ 27 – 29 ]. Its ability to enhance self-monitoring and self-regulation of decisional paradigms and conduct has earned RW a key role in competency-based medical practice and continuing professional development [ 30 – 36 ].…”