Core and Elective Curricula

One model that is gaining some traction in veterinary education, and that may help with the expansion of knowledge, is a core/elective or core/tracking/elective curriculum. These curricula identify the content that is deemed to be core and that all students must acquire, then allow students to choose additional courses to gain deeper knowledge based on their personal preferences and career goals. In a tracking curriculum, the additional courses are determined by the specific track on which a student wishes to focus, for example livestock, small animal, or public corporate. Alternatively, all additional courses may be optional.

In this model, the first requirement is to determine what is core, with optional material being determined by the resources available, for example faculty interest and expertise. As discussed earlier, the core content should focus on the required competencies, but the issue remains of how to determine the competencies that should be core for all students. A number of ways have been used in medical education to answer this questions, ranging from modified Delphi processes and other formal consultations to statistical and epidemiological methods, or more informal consultation with various stakeholders (Grant, 2013). One approach that is gaining traction in medical schools is the identification of index cases or presentations that are based on the different ways in which the population comes into contact with healthcare professionals (critical incident technique; Pavlish, Brown-Saltzman, and So, 2015). The core knowledge and skills that students need within each discipline are determined by what they need to know and do in order to understand and manage these core clinical problems.

Whatever method is chosen, care should be taken that the content reflects a consensus of views, including those of specialists and generalists. Specialists alone should not be permitted to determine the core curricular content in their own discipline (Leinster, 2013). The core content should be well understood and publicized, and take into consideration the vision of the college or school and the timeframe available for delivery of the core material. Finally, this process must include consideration of accreditation requirements as well as materials that will be included in licensing exams, such as the NAVLE.

Content Overload

One of the major concepts to emerge from educational research in the last 40 years is the idea that students take different approaches to learning (Marton and Saljo, 1976). Briefly, students who take a deep approach have the intention of understanding, engaging with, operating in, and valuing the subject, while students who take a surface approach tend not to have the primary intention of becoming interested in or understanding the subject, but rather their motivation tends to be jumping through the necessary hoops in order to acquire the mark, or the grade, or the qualification (Biggs, 1999; Lublin, 2003). The enemy of deep learning in any discipline is content overload (Ramsden, 1992), which leads to the superficial acquisition of facts, overwhelming any drive toward understanding and extracting meaning (May, 2008; May and Silva-Fletcher, 2015).

In conjunction with a competency-based approach to delineate and prioritize the core content to be included in a curriculum, the process of curricular mapping may assist with content overload. A comprehensive curricular map allows identification of material that should be included, as well as any uncoordinated rather than planned repetition, and, most importantly, redundant material that is irrelevant or not required. More discussion on curricular mapping can be found in Part One, Chapter 3: Curriculum Mapping.

“Just in Time” versus “Just in Case”

Another concept gaining increased attention in health sciences education is “just in time” teaching as opposed to “just in case”. This concept acknowledges the greatly expanded knowledge available on the Internet and the important skill of information literacy, with which students are able to source and evaluate this information correctly. In this way, students can apply or adapt the information in appropriate contexts when it is needed (“just in time”). This compares to the more historical approach in transmission-focused models of veterinary education where faculty take sole responsibility for sourcing the information that they determine to be needed, verify the quality of the information, and ask students to remember it “just in case” they might one day require it. The “just in time” model still acknowledges that essential concepts are core, but these act as frameworks for knowledge sourced on a “just in time” basis in response to a specific challenge (May and Silva-Fletcher, 2015).

Modular Curricular Design

A module is a self-contained course or unit of study. The course should have its own outcomes or learning objectives, activities, and assessments. In most veterinary curricula, students take more than one course at a time, with the courses taught conjointly and with a logical timing and sequence. Further, the timing of the courses should be planned according to a rational progression of knowledge and skills through the curriculum, although this may also be dependent on the availability of resources. Currently, a modular design is the most common curricular model in veterinary education.

A downside to this model is that knowledge and skills may be presented in isolation, with integration of subject areas occurring later, often by the student themselves, through use of the concepts in clinical settings.

Integrated Curricular Design

One organizational model that is becoming increasingly popular in medical education is an integrated curriculum. At its most fundamental, integration is the organization of teaching material to interrelate or unify subjects frequently taught in separate academic courses or departments (Malik and Malik, 2011). This approach helps students combine the facts they have learned and develop holistic approaches to medical problems.

The adoption of an integrated model may involve either a significant or a complete reorganization of the curriculum, so decisions must be made about the framework around which the content will be integrated. Different approaches to achieving integration have been used with varying degrees of success, but the most common involve either vertical or horizontal integration or a mixture of both. These models, together with other models of integration, are discussed in greater detail in Part Two, Chapter 5: Integrated Learning. It must also be remembered that whatever the final structure of the course, integration can only take place at the level of the students’ experience of learning. There is no point in integrating topics that are not coherent in their approach and level of difficulty.

Spiral Curriculum

Another organizational strategy that is frequently employed in curricular design is the concept of a spiral curriculum. The principal features of a spiral curriculum are the following:

• Topics, themes, or subjects are revisited on a number of occasions throughout the curriculum or program.
  
• Topics are revisited at increasing levels of difficulty.
  
• New learning is related to prior learning.
  
• The competence of the learner increases with each visit to the topic (Harden, 1999).

This spiral arrangement means that important themes are revisited, with continual development and reinforcement, over the duration of the program. Only by building a curricular structure based on increasing student challenge can progressive knowledge and skill development be fully realized (May and Silva-Fletcher, 2015).

Student-Centered versus Teacher-Centered Learning

In student-centered learning models, students are given more responsibility for their own learning, rather than the teacher wholly deciding what they will learn. While student-centered learning is consistent with adult learning theories, teachers still have an extremely important role as facilitators of learning. Students should not be abandoned to their own learning; rather, they need appropriate guidance and support throughout the program. In this way the teacher functions as a facilitator of learning, is intellectually critical, stimulating, and challenging, but within a learning context that emphasizes support and mutual respect (Grant, 2013). This shift away from teaching and toward learning is at the root of curricular models such as problem-based learning (PBL).

Inquiry-Based Learning versus Information-Oriented Learning

In order to achieve optimal learning outcomes, students should be actively engaged in their own learning. Strategies developed to try to optimize student engagement have included PBL and allied learning approaches (e.g., case-based learning, team-based learning, and task-based learning). In these learning paradigms, students explore scientific concepts in the context of clinical problems (or cases or tasks) and, rather than being provided with the knowledge (information-oriented learning), they establish their own knowledge and use it ultimately to solve clinical challenges. In this way, inquiry-based learning allows students to make connections between prior knowledge and new information, especially in the context of how they will use the information, and this facilitates knowledge storage and retrieval.

Problem-based learning, and allied strategies, may be employed in small groups, large groups, individualized learning, or with students working at a distance. The group approaches to learning are discussed further in Part Two, Chapter 6: Collaborative Learning. In addition, Harden and Davis developed 11 steps or stages that can be recognized in the continuum between inquiry-based learning and information-oriented learning (Harden and Davis, 1998).

Integration versus Subject- or Discipline-Based Learning

As discussed earlier in this chapter, medical education has moved from structuring the curriculum around the disciplines, first in basic sciences then in clinical medicine, to models where these are integrated.

In addition to integration within a curriculum between disciplines (horizontal integration) and between the basic and clinical sciences (vertical integration), there is also a move to interprofessional teaching, where integrated teaching and learning involve different healthcare professionals, and where students look at a subject from the perspective of other professions as well as their own. This concept is discussed further in Part Two, Chapter 7: Teaching Interprofessionalism.

Community-Based Learning versus Veterinary Teaching Hospital

Traditionally, clinical teaching in veterinary programs has largely been conducted in veterinary teaching hospitals (VTHs) that are owned and run by a college. In these hospitals, significant emphasis is placed on specialty practice with secondary or tertiary patient care. More recently there has been a recognition that these experiences may not provide veterinary students with sufficient exposure to common or routine clinical cases and there has been a move toward primary care or community practices. These clinics may be situated within VTHs, within off-site practices owned by the college, or in practices at large that have partnered with colleges to provide this clinical learning experience.

There is more detailed discussion of the learning that may occur in veterinary teaching hospitals in Part Three, Chapter 12: Learning in the Veterinary Teaching Hospital, and that in community-based practices in Part Three, Chapter 13: Learning in Real-World Settings.