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Integrating Disciplines: Conceptualisation to Actualisation

John Dyson

Faculty of DentistryThe University of Hong Kong

Faculty of Dentistry – The University of Hong KongFaculty of Dentistry – The University of Hong Kong

Faculty of Dentistry, HKUFaculty of Dentistry, HKU

Full-time academic staff 48Part-time academic staff 160

Undergraduate students 250 (5 x 50)Bachelor of Dental Surgery

Taught Postgraduate students 111Master Dental Surgery Master of Science Postgrad. Dip. in Dental SurgeryAdv. Dip. in Dental Surgery

Research Postgraduate students 49Doctor of PhilosophyMaster of Philosophy

Dental School established in 1980

Status as independent Faculty from 1982


SummarySummary

Integration – definitions, motivation, forms

Integrated undergraduate dental PBL curriculum introduced in Hong Kong in1998 – Overview– Reflections

• Factors enabling reform• Challenges• Rewards

Planning for extended curriculum in 2012 under Hong Kong’s educational reforms


What is integration?What is integration?

“Any intentional uniting or meshing of discrete elements or features constitutes some form of integration.”

Case R. 1991

“An integration is a philosophy of teaching in which content is drawn from several subject areas to focus on a particular topic or theme.” McBrien JL & Brandt RS, 1997

Integrated curriculum is “...education that is organized in such a way that it cuts across subject-matter lines, bringing together various aspects of the curriculum into meaningful association to focus upon broad areas of study.” Shoemaker 1989


Why integration ?Why integration ? respects the interconnectedness of knowledge

better appreciation of connections between concepts

knowledge not compartmentalized

increased ability to apply concepts to complex real-life situations

increased use of higher thinking skills

increased curiosity and motivation to learn

encourages creative thinking

reduced duplication

promotes greater efficiency (transferable skills)

heightened levels of collegial interaction


Approaches to integration in higher educationApproaches to integration in higher education

Separate discipline-based courses aligned to theme

Themed course taught by interdisciplinary team

Project work

Experiential learning (e.g. internship)

Case-based learning, problem-based learning


Undergraduate Dental Education in Hong KongUndergraduate Dental Education in Hong Kong

1980 First undergraduate dental curriculum in Hong Kong commenced


Basic, medical and dental sciencesBasic, medical and dental sciences in the dental curriculum in the dental curriculum

Medical Sciences

Clinical Dental Subjects

Traditional dental curriculum

Basic Sciences

Anatomy

Physiology

Biochemistry

Pathology

Microbiology

Medicine

Surgery

Operative Dentistry Oral Rehabilitation

Endodontics Children’s Dentistry

Periodontology Orthodontics

Dental Public Health

Oral and Maxillofacial Surgery


Basic, medical and dental sciencesBasic, medical and dental sciences in the dental curriculum in the dental curriculum

HKU 1980 dental curriculum

Traditional dental curriculum

Medical Sciences

Clinical Dental SubjectsBasic Sciences

Rudimentary vertical integration

“Diagonally integrated”



1980

Features of first curriculum:

• Integration of learning between clinical subjects and supporting sciences

• Learning in small groups

• Active learning promoted


1990s

•Focus on content, - much delivered as

lectures

• Overfilled

• Duplication

• Integration between subjects limited



1996

Routine external review of Faculty of Dentistry initiated by HKU

Outcome -Faculty agreed to• restructure (matrix management) • reform curriculum

Faculty ReviewFaculty Review


Departmental Structure Departmental Structure (pre-1996)(pre-1996)

Dean

(Elected)

Heads of Departments

Conservative Dentistry

Prosthetic Dentistry

Periodontology and

Public Health

Oral and Maxillofacial

Surgery

Orthodontics and

Children’s Dentistry

Dep

artm

ents

Management Team


Current Matrix StructureCurrent Matrix Structure

Associate Deans

Dean

(Appointed, Executive)

Undergraduate Education

Postgraduate Education

Research and

Discovery

External Affairs

Global and Mainland

Affairs

Areas/Disciplines

Family Dentistry

Oral Rehabiltation

Periodontology

etc.

Management Team


Undergraduate Dental Curriculum ReformUndergraduate Dental Curriculum Reform

May 1996– Review of Faculty of Dentistry (initiated by HKU)– Faculty agreed to restructure and reform curriculum

May 1997

– Faculty Curriculum Task Force formed

– Information collected (workshops, visits to overseas institutions, local & overseas consultants)

– Curriculum planning

– Staff orientation/training

September 1998– PBL curriculum commenced for new intake


The 1998 undergraduate dental curriculumThe 1998 undergraduate dental curriculum

Integration of basic and clinical sciences

through open-discovery model of problem-

based learning (PBL).

No traditional-style lectures or seminars.


Implementation considerationsImplementation considerations

Leadership Funding

– development and implementation costs

Facilities – tutorial rooms– library resources

Staff development– reorientation– training (facilitators, problem writers, clinical teachers

etc.)


Dean

Associate Dean (UE)

Assistant Dean (UE)

Faculty Curriculum Development Committee

Year Course Director

Year Curriculum Development Group

Year ProblemDevelopment Group

Undergraduate Curriculum Management

Subject representatives


Programme aims Programme aims – Statement of Intent– Statement of Intent

To produce:

Competent and caring dental practitioners able to:– Think independently and critically

– Respond quickly to patients with complex problems

– Adapt to future changes occurring in dentistry

– Remain contemporary in their skills and knowledge

Life-long learners able to:– Access and evaluate information from many sources

– Oversee their own professional continuing education

– (able to contribute to generation of new knowledge)


Curriculum DesignCurriculum Design

Statement of IntentStatement of Intent

Competency StatementsCompetency Statements

Learning ObjectivesLearning Objectives

Curriculum StreamsCurriculum StreamsLearning themes distributed across

the years 1-5


6-8 students per group

Staff facilitators

- not content experts

- trained in process

PBL tutorialsPBL tutorials


e.g. photos, dental records, documents, specimens, models,

video

Components of a PBL problem

Written problem statement

Presentation and inquiry materials

One of your friends from the engineering faculty recently invited you to visit his home in Western Guangdong province for the weekend. …… you noticed that many of the adults appeared to have worn down and discoloured teeth …… a village elder approached you and said it would be a great privilege if you would consider coming to the village .. to provide dental treatment care for his community



Anticipated Learning Issues identified under:

•Biomedical Sciences

•Behavioural Sciences

•Social Sciences

•Clinical Dental Sciences

•Ethics, jurisprudence, practice management etc.



Facilitator notesOverview of learning issues

Relevance to problemTrigger questions

Product requestStatement of product requirement

e.g. concept map, instruction leaflet, letter, poster, role play


PBL tutorial 1PBL tutorial 1


Facts Ideas Learning Issues

Relevant factsidentified

Ideas/hypotheses generated

– based on prior knowledge

Issues for further study

– possible resources discussed



Learning opportunitiesLearning opportunities

2 – 4 self-directed learning sessions







Practical – e.g. laboratory practical, consultation clinic





Resource staff





Resource staff

E-learning website





Resource staff

E-learning website

Large group discussions

“Resource sessions” at end of each module (7-8 weeks) – on request, interactive



Discuss problem again and share new knowledge

Evaluate own performance

Discuss strategy for preparing product


Techniques courses - Simulation laboratory

Demonstrations

Practice

Worksheets

(Integration with Dental Materials Science, Dental Technology etc.)

Clinical skillsClinical skills


Supervised clinical practice in Polyclinics• briefing/debriefing discussions – sharing, reflection (clinical

issues and supporting sciences)• supervised by staff team comprising representatives from

relevant disciplines

Clinical experienceClinical experience


Community outreach clinics– briefing/debriefing discussions

Clinical experienceClinical experience


Additional learning opportunitiesAdditional learning opportunities

Community dental health projects


Additional learning opportunitiesAdditional learning opportunities

Community dental health projects Electives

– Overseas attachment (3 weeks)


Assessment PrinciplesAssessment Principles

• Knowledge: application / integration

• Reasoning / problem-solving

• Collaboration / interpersonal skills

• Professional attitudes / behaviours

• Skills of profession / workplace

Formative Summative


Assessment toolsAssessment tools

Facilitator / tutor assessment for each tutorial/clinical session (knowledge, behaviour, skills)

Key Skills Assessment (key clinical competencies – must pass all)

Triple Jump Assessment (PBL process)

OSCE (Objective structured clinical examinations)

Clinical Practice Assessment (case-based)

“Mini-cases” (sequentially disclosed information)

Project reports

Student portfolio (reflective – reports on patient cases, projects etc.)


Curriculum evaluation and review Curriculum evaluation and review Internal

– Student feedback• written evaluation of tutors and courses (4 x year)• meetings with group representatives (4 x year)• (student personal learning journals)

– Graduate/employer feedback– Staff feedback

• facilitator meetings (after each problem)• written evaluation of problem scenarios

External– external examiners’ reports– reviews by invited consultants


Ongoing developmentsOngoing developments

Appointment of new posts in Dental Education/E-learning, Director of Polyclinics

Enhanced web-based learning, research-based learning

New clinical techniques

Refinements to assessments and curriculum management structure

Recognizing and rewarding good teaching


Reflections on the reformReflections on the reform

Enabling factors

Challenges

Rewards


Enabling factorsEnabling factors

Management structure

University support

Leadership - determination and dedication of Task Force

Faculty commitment – critical mass of support

Workshops by local and visiting academics


Challenges - StaffChallenges - Staff Staff resistance

– Leadership

– Workshops by invited academics

Concerns about loss of disciplinary autonomy

– Involvement of all areas in planning and management

Protection of principles

– Ongoing workshops

Perceptions on career advancement in disciplines

– Recognition of good teaching in promotions and tenure decisions

Time

– Time compensation for development work


Challenges - StudentsChallenges - Students Concerns regarding lack of guidance

– Information for student applicants

– Induction programme

– Improved access to resource staff through websites

– Ongoing student support (Student Progress Coordinators, Personal

Tutors)


Challenges Challenges - Resources and facilities- Resources and facilities

Resources

– University Development Funds

– Teaching Development Grants

Facilities

– PBL Suite (suite of 15 tutorial rooms)

– Library discussion rooms

– Multiple copies of textbooks


RewardsRewards

Active learners: Involved, self-critical, and questioning

Better learning skills: Integrated knowledge base, better application of knowledge to clinical problems

Improved language and communication skills

More enjoyable for most students and teachers

Rationalization of curriculum content

Favorable external reviews

(Better performance in external professional exams)


Curriculum reform in Hong KongCurriculum reform in Hong Kong

The secondary school curriculum across Hong Kong shortened from seven to six years.

5 + 2 + 3 3 + 3 + 4

From 2012 the length of the undergraduate university curriculum in Hong Kong extended by one year.


Undergraduate education reform at HKUUndergraduate education reform at HKU

“Distinctive features” of the HKU Curriculum:

Interdisciplinary inquiry Multidisciplinary collaboration Polycontextual inquiry Diverse learning experiences Multiple forms of learning and assessment Engagement with local and global communities Development of civic and moral values

Common core curriculum Outcome based approach to teaching and learning Student-centered learning


Six educational aimsSix educational aims for HKUfor HKU

To enable our students to develop capabilities in:

Critical intellectual inquiry in the disciplines, postgraduate research and life-long learning

Tackling novel situations and ill-defined problems, and creative thinking

Critical self-reflection and greater understanding of others

Intercultural communication, multicultural understanding and global citizenship

Communication and collaboration

Leadership and advocacy for the improvement of the human condition

Faculty of Dentistry – The University of Hong KongFaculty of Dentistry – The University of Hong KongThank you

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