Keele Research Repository

Introduction: Integrated undergraduate health professions curricula aim to produce graduates who are prepared to meet current and future healthcare needs. Integration is advocated by pharmacy regulators as the perceived optimum way of preparing students for first registration as pharmacists. Integration can be described by model of integration; horizontal, vertical or spiral, themes for integration or by integrative teaching and learning approaches. Harden's integration ladder has been operationalised by the General Pharmaceutical Council as three levels: “fully”, “partially” and “not integrated” curricula1.

Aim: This scoping review aimed to explore health professions education literature to inform the design of integrated pharmacy curricula. This review asks: what is meant by integration in health professions curricula?

Method: The Arksey and O'Malley scoping review framework was utilised2. Ovid MEDLINE, Embase, Scopus, Web of Science and ERIC were searched for studies published up to May 2018. Research papers were eligible for inclusion if they described curriculum integration in undergraduate health professions curricula. Models of integration, themes for integration, teaching and learning approaches and level of integration were defined to support data extraction.

Results: 9345 studies were identified and 136 were included. 12.5% of included studies included a definition of integration. The majority of studies described horizontal integration (n = 87). Various teaching and learning approaches were described, including experiential (n = 43), case‐based (n = 42) and problem‐based (n = 38) learning. Systems‐based teaching (n = 56) was the most common theme reported. The majority of curricula were classified as “partially integrated” i.e. levels 5–7 on Harden's ladder (n = 101). 81 studies reported perception outcomes. Only three studies reported outcomes beyond perception. Reported outcomes were mostly positive and included knowledge gains, increased appreciation of relevance, increased motivation and improved communication. Increased stress, difficulty understanding basic concepts and time constraints were also reported.

Conclusions: Various themes for integration and integrative teaching and learning approaches are used. A lack of evidence for integration remains due to reliance on perception data. There is a need for integration to be explicitly defined by curriculum developers and researchers. Attention should be given to model, theme, teaching and learning approach, level of integration and outcomes.