A comparision of the discipline-based and integrated systems of undergraduate medical education in terms of critical thinking, learning approach and academic performance of students

Date of Award


Document Type


Degree Name

Master of Health Professions Education (MPHE)


Educational Development


Past four decades of medical education have been heavily occupied by the debate relating to various aspects of development, implementation and evaluation of integrated curricula at the undergraduate level. As more and more of the medical schools have started adopting various forms of integrated curricula it becomes imperative to evaluate the effectiveness of such educational interventions. Purpose:This study aims to compare the effectiveness of discipline-based and integrated system of medical education (DBME and ISME) in terms of critical thinking, learning approach and academic performance of undergraduate medical students.Methods: Two cohorts of undergraduate medical students from Peshawar Medical College; one belonging to the DBME (n=94) and the other to the ISME (n=95) were included. The Watson-Glaser Critical Thinking Appraisal (WGCTA) form-A, Revised 2-Factor Study Process Questionnaire (R-SPQ-2F) and annual university examination results were used to assess the critical thinking capability, learning approach and academic performance of students, respectively. Independent samples t-test at 95% confidence level was used for comparison amongst the two groups on these measures. Pearson's correlation was used to determine any relationship between critical thinking, learning approach and academic performance of students. Results: Critical thinking ability of students of ISME was significantly higher than those of DBME (p=0.0002). Both groups demonstrated a predominant deep approach to learning. Students of ISME were less likely to engage in superficial learning as compared to students of DBME (p=0.026). Students of ISME demonstrated superior academic performance on university examinations than students of DBME (p=0.012). Overall, there was a moderately positive correlation between critical thinking and academic performance, and a negative correlation of superficial approach to learning with critical thinking and academic performance of students. Conclusion: ISME was found to be more effective, in terms of students' critical thinking, learning approach and academic performance, as compared to DBME. Academic performance was found to have a positive relationship with critical thinking and a negative relationship with superficial approach to learning.

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