title: Students' perceptions of vertical and horizontal integration in a discipline-based dental school.
abstract: BACKGROUND
  Integration is a key concern in discipline-based undergraduate dental curricula. Therefore, this study compared feedback on integration from students who participated in different instructional designs in a Comprehensive Patient Care course.
  
  
  METHODS
  The study was conducted at the University of Pretoria (2009-2011). Third-year cohorts (Cohorts A, B and C) participated in pre-clinical case-based learning, whilst fourth-year cohorts (Cohorts D and E) received didactic teaching in Comprehensive Patient Care. Cohorts A, D and E practised clinical Comprehensive Patient Care in a discipline-based clinic. Cohort B conducted their Comprehensive Patient Care patient examinations in a dedicated facility supervised by dedicated faculty responsible to teach integration. Students had to indicate on visual analogue scales whether the way they were taught at the school helped them to integrate knowledge from the same (horizontal integration) and preceding (vertical integration) year of study. The end-points of the scales were defined as 'definitely' and 'not at all'. Analysis of variance (ANOVA) was employed to measure the differences between cohorts according to the year of study.
  
  
  RESULTS
  Third-year case-based learning cohorts rated the horizontal integration close to 80/100 and vertical integration ranging from 64 to 71/100. In year four, Cohort B rated vertical and horizontal integration 9-15% higher (ANOVA, P < 0.05) than Cohorts A and D. In year five, Cohort A rated vertical and horizontal integration 11-18% higher (ANOVA, P < 0.05) than Cohorts D and E.
  
  
  CONCLUSIONS
  Pre-clinical case-based learning and Comprehensive Patient Care supervised by dedicated faculty were associated with more favourable perceptions about integration in the discipline-based undergraduate dental curriculum.
authors.affiliation: Dental Management Sciences, University of Pretoria, Pretoria, South Africa.
authors.forename: T C
authors.initials: TC
authors.lastname: Postma
authors.affiliation: Dental Management Sciences, University of Pretoria, Pretoria, South Africa.
authors.forename: J G
authors.initials: JG
authors.lastname: White
mesh_terms: D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D003479:Curriculum; D004497:Education, Dental / Q000379:methods*; D006801:Humans; D018794:Problem-Based Learning; D012575:Schools, Dental; D013019:South Africa; D013335:Students, Dental
keywords: basic medical sciences; case studies; clinical reasoning; dental education; integration; simulation