Holistic medical education

THIS MAY BE a timely addition to medical school bookshelves, as so many new medical schools are engaged in curriculum development. Written by a respected Australian medical educator, the book promotes an integrated approach, and then attempts a comprehensive coverage of issues concerning design, implementation, assessment and evaluation, and blending theory with practice. The strength of the book lies in the international experience of the author who has, among other things, worked as a senior academic at the University of New South Wales in Sydney and the Arabian Gulf University in Bahrain.

The final two chapters are the most valuable, where this experience is used to describe common pitfalls, and four case studies highlight the lessons learned from well intentioned, but not always successful, attempts to redesign a medical curriculum. However, the case studies are not analysed in great depth and appear almost as a postscript. It may have been better, as in a problem-based curriculum, to present case studies as the lead-in to each chapter, with the analysis combining theory and practice to demonstrate lessons learned about integration.

Other strengths of the book are: the commentary on integrated vs integrating curricula, a perceptive issue (Chapter 1); the brief but accessible history of curriculum integration (Chapter 2); the discussion on the advantages and disadvantages of integration (Chapter 5); and the list of evaluation questions to consider (Chapter 7).

The major weakness of the book is the relatively scant presentation of a theoretical basis for integration, and methods for achieving, assessing and evaluating integrated learning. Some recent research literature is also not cited, particularly in integrated and workplace-based assessment and evaluation methods. Further, little is said about qualitative evaluation, which may be the stronger approach to exploring how learners perceive and gain from different curriculum approaches.

The material is probably of more value to less experienced educators, who should be able to follow the links to the literature and expand their reading. I would suggest that readers work backwards from the final two chapters to the earlier discussions of emerging issues.