I feel smart learners are becoming surface learners in the integrated curriculum by juggling with only the learning outcomes included in the blueprint without processing the information. They calculate the bare minimum content required just to pass. They are not ready to come out of their comfort zone to progress by acquiring hard-core concepts at the level of application and synthesis. They appear in a module exam and stop relating it to other modules.

Integrated curriculum is being implemented at the cost of lack of ownership by subject specialists. System-based modules lay the foundation of disciplines on Anatomy but not on the themes associated with clinical features like chest pain. When diseases are studied within systems, the integration is itself disintegrated into anatomical boundaries.

Problem-based learning from which students can derive their own learning outcomes to solve the scenario remains the only hope to integrate the systems, as diseases seldom restrict themselves to one system. As assessment drives learning, PBL may be assessed by case-cluster-MCQs and integrated viva by relevant subject specialists. Being a student-centered methodology, adding to the burden of an integrated curriculum involving multiple subjects, PBL is usually neglected by the student body. There is a dire need to innovate PBL and make it interesting by using students as simulated patients and by allowing them into doctor-patient-role-play, whereas the remaining students may be engaged in healthy critique and feedback along with critical thinking, leadership and teamwork to achieve academic as well as social learning. PBL workshops with faculty and students may be beneficial.

The relatively new concept of “patients as educators of students” may be practiced by recruiting actors and real patients carefully through interviews and seeking their consent for history-taking and/or physical examination. Feedback and assessment by simulated patients may contribute to real-patient safety. Their video may be created as a future learning resource. Smart learners need smart teachers to handle them along with their modern curriculum.

Prof. Dr. Samina Malik HOD Physiology, University College of Medicine and Dentistry, The University of Lahore PBL Country head for Pakistan, Asia-Pacific Association on PBL in Health Sciences (APA-PHS) Secretary General, South Asian Association of Physiologists Masters in Med Edu student at Dundee university, UK Member APS, Teaching of Physiology section (Member No. 00307332)