Impact on knowledge acquisition of the transition from a conventional to an integrated contextual medical curriculum.

CONTEXT This study set out to test the hypotheses that after the implementation of an integrated contextual medical curriculum (ICMC), ICMC students would attain higher levels of knowledge in both the basic and clinical sciences at an earlier stage than conventional medical curriculum (CMC) students, that ICMC students would perform significantly better on knowledge tests at the end of their education and, finally, that ICMC students would show a more linear acquisition of knowledge in the basic and clinical sciences. METHODS We drew upon the Dutch Inter-University Progress Test (PT) to measure impact on knowledge acquisition and compared PT scores of 393 CMC students with scores of 1028 ICMC students (Years 2-6) in a cross-sectional design. We also compared the scores of 112 CMC students with those of 197 ICMC students in Years 3-6 in a longitudinal design. RESULTS As expected, ICMC students showed a steeper learning curve in both the basic and clinical sciences: at the end of their training students had attained higher levels of knowledge in both domains. The learning curve pertaining to the clinical sciences was almost linear, whereas that for the basic sciences showed a sharper rise, indicating a continuing growth of knowledge. CONCLUSIONS The differential impact on knowledge acquisition of conventional and innovative curricula has seldom been studied in a longitudinal and cross-sectional design. This study confirmed our assumptions about the potential of an integrated contextual curriculum. The differences observed in ICMC students were attributed to the stronger emphasis on clinically relevant basic sciences in the early years of the ICMC and to the stronger integration of basic and clinical sciences in the ICMC.