A Theoretical Framework and Process for Implementing a Spiral Integrated Curriculum in a Physical Therapist Education Program

Abstract

Background and Purpose. In 2016, faculty at the MGH Institute of Health Professions implemented a new physical therapist education curriculum based on contemporary theoretical models of learning to address shortcomings of the existing, traditional curriculum. Course content was siloed, students were spending too much time in class to the detriment of self-directed learning, and there was unwarranted repetition of content. Students seemed to emphasize superficial learning in an effort to pass numerous examinations across multiple courses, and they were learning factual knowledge in isolation. The purpose of this article is to describe a new curricular model framed within theoretical perspectives on learning, including cognitive load theory and constructivism. We also describe how we structured decisions about curriculum at the program, course, session, and assessment levels. Method/Model Description and Evaluation. We developed a curriculum that represents spiral integration, including integration of the foundational, clinical, and behavioral sciences at the program, course, session, and assessment levels. Courses employ increasingly complex patient narratives that present patients holistically. Course objectives focus on the higher levels of the learning taxonomies. Outcomes. The curriculum not only integrates content within and across courses but also uses constructivist learning theory by explicitly engaging students in iterative learning with emphasis on depth versus breadth of information. Discussion and Conclusion. The approach to teaching is focused on stimulating curiosity and motivating learning through patient narratives and early focus on clinical reasoning. Cognitive load is addressed by reducing in-class time and having students take only 1 course at a time. An ongoing process of critical study, review, and revision of the curriculum will continue to improve students’ learning experiences, environment, and outcomes.