Systemic Barriers to Curriculum Adaptation for Rapidly Changing Knowledge in Medical Education: Qualitative Study.

چکیده اصلی

BACKGROUND: For this study, digitalization in medicine was used as an illustrative case to investigate how medical curricula respond to rapidly changing knowledge. Digitalization is transforming the way medicine and health care are provided and experienced. Experts have suggested various topics for medical curricula to keep pace with rapidly evolving knowledge. However, adapting these curricula remains a lengthy process that often lacks an interdisciplinary approach. OBJECTIVE: The perspectives of curriculum governing bodies and the boards responsible for curriculum operations at 2 medical universities were examined regarding the need for curriculum changes to account for digitalization in medicine, as well as the difficulties in adapting the curriculum to ever-growing knowledge. We identify and suggest ways to achieve more agile curriculum development. METHODS: This study consists of a qualitative analysis of governing policy frameworks and a qualitative study involving 14 video interviews. The interviews were performed with members of university curriculum governing bodies and the boards responsible for curriculum operations. RESULTS: All participants agreed that digitalization will reshape the medical profession by reducing physical contact, enhancing data-driven communication, and streamlining administrative processes. They highlighted the need for graduates to acquire digital literacy, critical evaluation skills, and a basic understanding of data and statistics. Yet, despite being designed as an integrated program, most participants noted that curricula have become fragmented over time due to a lack of coordination between curriculum modules. Furthermore, current processes lead to a siloed perspective, where limited coordination between modules makes it difficult to implement new knowledge holistically. This lack of intermodule alignment emerged as a key barrier to coherent curricular change. Learning objectives were identified as a promising but underutilized tool for monitoring content, aligning modules, and ensuring that emerging topics such as digitalization are integrated consistently. CONCLUSIONS: Most participants agreed that current processes for monitoring and updating curricula are not efficiently designed, tending to be too static and focusing primarily on the advancement of subject-specific medical knowledge. To prepare current and future students for a rapidly changing world, curriculum processes should evolve from static, fragmented structures to more agile, integrated systems. By mapping the survey results to the curriculum development frameworks of Kern and Harden, we find that the challenge lies not so much in adding new content, but rather in designing curriculum processes that achieve a holistic overview. Strengthening the use of learning objectives as a dynamic monitoring and alignment tool offers a concrete opportunity to integrate rapidly changing knowledge holistically.

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