Subject matter changes in the dental curriculum: A scoping review of the last two decades

PURPOSE

In recent years, dental education has witnessed significant advancements and curriculum shifts in response to evolving healthcare needs, technological advances, and changing societal demands. As a result, dental universities worldwide have undergone substantial curriculum changes to ensure the adequate education and training of future dental professionals. The purpose of this study was to delineate the curriculum innovations over the past 20 years, with a focus on content within the current dental curriculum at universities worldwide.

METHOD

The articles reviewed for this manuscript were published from 2000 to June 2023. Search queries were conducted in four databases: Embase, PubMed, Web of Science, and ERIC, yielding 367 unique studies. Of these, 31 were included in the final synthesis.

RESULTS

The nine principal subject matter themes identified in the thematic analysis of these articles were critical scientific thinking, computational thinking, global mindset, geriatric dental care, interprofessional teamwork, transition to practice, local community, integration, and lifelong learning. The themes were modeled and mapped in a three-axis figure, elucidating the interconnections between the themes.

CONCLUSION

The identified themes signify the trajectory that dental education has taken and provide insights into the future course of the dental profession.

A novel approach for designing hands-on training programs using Quick Reference code-linked videos

Providing training on the proper use of technology in the context of a large number of learners and limited faculty availability is a constant challenge to dental schools. We found the implementation of a QR-code-based autonomous program design to be efficient and effective at providing trainees hands-on training with newly installed perioperative equipment.

Preparing learners to ACT as change agents: Early implementation of leadership curricula in dental education

OBJECTIVE

Graduates of dental schools are expected to become leaders in their practices, communities, and profession. Yet, formal leadership training is underutilized in U.S. dental school curricula to help learners develop these skills. The objective of this study was to understand third- and fourth-year dental students' perceptions of their initial semester of Bell Leadership Institute training as part of the novel Advocate, Clinician, Thinker curriculum at the UNC Adams School of Dentistry.

METHODS

Focus groups of 52 third- and fourth-year dental students were conducted after the completion of the first semester of leadership seminars. Session notes were transcribed, and qualitative analysis was performed to help elucidate student perceptions of the value and pertinence of the leadership seminars.

RESULTS

Participants valued the opportunities to self-reflect, develop listening skills, and learn strategies to address and mitigate conflict through the leadership seminars. Perceptions of seminar length, frequency, and structure were varied. Participants also noted that explicit connections and applications of leadership topics to the field of dentistry would improve the quality of the programing. Feedback from 52 focus group participants suggests a general appreciation for curriculum-integrated leadership training.

CONCLUSION

Early implementation of seminar-style leadership training in dental school curricula appears to be a productive avenue for developing critical leadership skills in dental school graduates.

Using a change management model to develop and implement dental curricula: A case study

Curriculum transformation is a guiding principle and driving force to continued institutional growth and innovation in oral health education. The transformation process starts from the need and desire for change to achieve the strategic goals of curriculum invocation. The design and implementation process must follow a systematic approach to ensure the oral health curricula are meeting the demands of preparing learners for their future careers and are in line with the institutional strategic goals and processes. The process of curriculum transformation needs to be carefully crafted and implemented to include all constituents and have clear and measurable outcomes to define its path and results. The University of North Carolina at Chapel Hill Adams School of Dentistry is undergoing the journey of oral health curriculum innovation and transformation. The goal of this paper is to describe the change management process using Kotter's organizational model that may apply to other schools aiming to innovate dental curricula.

Utilizing an organizational development framework as a road map for creating a technology-driven agile curriculum in predoctoral dental education

The landscape of dental education is undergoing a paradigm shift from both the learner's and teacher's perspectives. Evolving technologies, including artificial intelligence, virtual reality, augmented reality, and mixed reality, are providing synergistic opportunities to create new and exciting educational platforms. The evolution of these platforms will likely play a significant role in dental education. This is especially true in the wake of calamities like the COVID-19 pandemic during which educational activities had to be shutdown or moved online. This experience demonstrated that it is prudent to develop curricula that are both agile and efficient via creating hybrid courses that provide effective learning experiences regardless of the mode of delivery. Although there is growing interest in incorporating technology into dental education, there are few examples of how to actually manage the implementation of technology into the curriculum. In this paper, we provide a road map for incorporating technology into the dental curriculum to create agility and discuss challenges and possible solutions.

Optimizing teaching effectiveness in dental education for a new generation of learners

PURPOSE

Today's dental students, Generation Z (Gen Z), are said to learn differently than those of previous generations. As generations of dental students vary, our teaching styles must keep up with unique and changing groups of individuals.

METHODS

This article discusses learner-focused teaching methods including techniques that address the characteristics of Gen Z learners. Blended learning methods that combine online media with traditional face-to-face sessions, team-based learning, and a flipped classroom format have previously been suggested as ways to increase learning effectiveness and student satisfaction.

RESULTS

In this paper, the characteristics and preferences of Gen Z students are described along with the challenges they create with conventional teaching methods. An implementation strategy using principles from organizational agility and Bolman and Deal's Four Frames Model is proposed for dental schools to transition to a more learner-centered teaching approach.

CONCLUSIONS

The suggested strategy can be customized and could be useful to schools that wish to enhance their teaching methods to meet the learning needs of Gen Z dental students and beyond.

Preparing for implementation of an entrustable professional activity assessment framework

Following the adoption of competency-based education in dentistry in the 1990s, entrustable professional activities (EPAs) were introduced in the field of medicine in the mid-2000s to help educators better determine the competence of trainees. More recently, the field of dental education has begun exploring EPAs as a framework for assessing competence while ensuring compliance with accreditation standards. This paper explores one dental school's process of preparing for implementation of a major curriculum change using an EPA assessment framework, shifting away from the use of singular assessments for competency determination to a global and longitudinal approach using a constellation of data to determine practice readiness. This paper describes how the EPA framework was developed, including the complementary capacities, assessment tool development and programming, and data reporting to follow learner progression and determine practice readiness. We discuss lessons learned leading up to implementation, and we position this perspective as a space to describe opportunities and complexities to consider when using a longitudinal assessment system. We attend to the tension between the current language of Commission of Dental Accreditation Standards as "competencies" and the evolving conversation of operationalizing EPAs while addressing accreditation Standards. To do this, we describe the process of finalizing our EPA framework and preparing for initial implementation in a new curriculum.

The use of podcasts as a tool to teach clinical reasoning: a pseudorandomized and controlled study

OBJECTIVES

Podcasts have emerged as an efficient method for widespread delivery of educational clinical reasoning (CR) content. However, the impact of such podcasts on CR skills has not been established. We set out to determine whether exposure to expert reasoning in a podcast format leads to enhanced CR skills.

METHODS

This is a pseudo-randomized study of third-year medical students (MS3) to either a control group (n=22) of pre-established online CR modules, or intervention group (n=26) with both the online modules and novel CR podcasts. The podcasts were developed from four "clinical unknown" cases presented to expert clinician educators. After completing these assignments in weeks 1-2, weekly history and physical (H&P) notes were collected and graded according to the validated IDEA rubric between weeks 3-7. A longitudinal regression model was used to compare the H&P IDEA scores over time. Usage and perception of the podcasts was also assessed via survey data.

RESULTS

Ninety control and 128 intervention H&Ps were scored. There was no statistical difference in the change of average IDEA scores between intervention (0.92, p=0.35) and control groups (-0.33, p=0.83). Intervention participants positively received the podcasts and noted increased discussion of CR principles from both their ward (3.1 vs. 2.4, p=0.08) and teaching (3.2 vs. 2.5, p=0.05) attendings.

CONCLUSIONS

This is the first objective, pseudo-randomized assessment of CR podcasts in undergraduate medical education. While we did not demonstrate significant improvement in IDEA scores, our data show that podcasts are a well-received tool that can prime learners to recognize CR principles.

Tell Me Your Story: Experiential learning using in-home interviews of healthy older adults

PURPOSE

To create a curriculum innovation for early preclinical medical students to explore personal perspectives by listening to and learning from the lived experience of community-living older adults.

METHOD

Tell Me Your Story (TMYS) paired first-year medical students (MS1s) with community-dwelling older adult partners (OAPs) residing in the independent living portion of a continuing care retirement community (CCRC) for a half-day educational experience. MS1s conducted 1-hour semi-structured interviews with their OAP and then formed small groups with geriatric faculty members to explore experiences and views that were either reinforced or challenged. The authors evaluated the effectiveness of this exercise using post-activity surveys. A mixed-methods analysis of 7 years of data (2013-2019) was conducted.

RESULTS

TMYS had 1251 MS1 participants from 2013 to 2019. Students completed 1052 surveys for a response rate of 84%. During the semi-structured interview with OAP, the frequency of issues discussed included relationships (94%), professionalism/art of medicine (91%), healthcare accessibility (83%), death/dying/grieving/loss (72%), nutrition (69%), ethics (64%), and cultural competence (61%). Exactly 97% (n = 1023) responded that the overall organization was "good, very good or excellent." The most prominent themes identified by student responses highlighted person-centered care, patient perspective, life experience/personal stories, and doctor-patient relationship. Fifty-three faculty members completed the post-program survey. Exactly 100% (53/53) rated the quality of this exercise as an educational experience high.

CONCLUSION

TMYS was highly valued by students and provided an important experiential learning activity in preclinical medical education. Themes related to person-centered care emerged from the intervention.

Opportunities for narrative medicine in dental education and practice, a narrative review

PURPOSE/OBJECTIVES

Reflection is one of four components of the experiential learning cycle and is often the one overlooked. This practice can be used in graduate-level health care education, such as medicine and dentistry. This metacognitive practice allows students to conceptualize learning in a clinical setting and apply this knowledge to new scenarios. Reflective practice can be taught using different modalities of narrative medicine, and several studies have studied its effectiveness in areas such as professional development, collaboration, communication among others. Most of these studies, however, have been conducted solely in the medical setting, and narrative medicine may have useful application in the practice and teaching of dentistry.

METHODS

This literature review examined the outcomes of narrative medicine in medical studies concerning reflection and hypothesized their benefits to dental education. The studies reviewed were chosen by utilizing key term searches of the National Center for Biotechnology Information PubMed library and qualitative factor analysis by study team investigators. Elective-based, prospective enrollment and whole cohort participation programs were analyzed for potential effectiveness in dental education.

RESULTS

The most feasible programs for potential integration into dental curricula are elective-based, small-group, graduate-level courses with a level of evaluation such as residency competencies, as demonstrated by Arntfield et al. CONCLUSION(S): These programs should be investigated further to evaluate their potential in improving reflective skills of students, and ultimately in improving their experiential learning experience.

Perspective of students in the Global Citizenship in Dentistry as an international peer learning experience

OBJECTIVE

To explore the achievement and perception of dental students in an international peer learning setting via the Global Citizenship in Dentistry (GCD) program.

METHODS

In the GCD program, year-2 dental students from universities in Egypt, Hong Kong, Malaysia, UK, and the United States developed a portfolio of a restorative procedure in simulation laboratory and uploaded to an online platform (https://gcd.hku.hk/). Through the platform, the students left comments on each other's portfolios to share and discuss their knowledge and experiences on restorative dentistry. This study invited students from Hong Kong in 2018-2019 to complete an open-ended questionnaire to explore their experience on the GCD program. The feedback was compiled and analyzed.

RESULTS

All 71 year-2 students completed the questionnaire. Their most dominant comments were positive feelings about learning different clinical principles and methods from universities abroad. The students also enjoyed the cultural exchange from the comfort of their own devices. Other recurrent comments included the improvement of the skills of communication and comments on the peers' work in a professional manner. The students were enthusiastic about being able to apply their critical thinking in evaluating their work. They shared their learning barriers, including the extra time needed for the program, some unenthusiastic responses from groupmates, and delayed replies from peers. They made suggestions to remove the barriers in the learning process of the GCD program.

CONCLUSION

Students generally welcomed the GCD program and benefitted from the global academic exchange, development of critical thinking, enhancing professional communication skills, as well as opportunities of cultural exchange.

Collaborating and teaching a synchronous, multi-university, virtual course: Health policy and access to dental care

PURPOSE

In response to COVID-19, dental educators have been tasked with maintaining the quality of education while reducing cost, increasing efficiency, and leveraging technology.

METHODS

This collaborative, multisite virtual health policy course used the Staged Self-Directed Learning Model (SSDL) to lead a diverse group of students studying health policy. Twelve Core sessions were offered with three additional sessions in August or December for a total of 15 total synchronous Zoom sessions that covered policy issues on supply, demand, and need for dental care.

RESULTS

Twenty-eight students, seven lead instructors, and two course directors from six schools reported positive feedback on the course format, use of technology and the SSDL model, and breadth of topics presented. Participation by universities in four states with differing health policies stimulated virtual classroom discussions.

CONCLUSION

In conclusion, collaborative interinstitutional virtual teaching and learning is cost effective, efficient, and engaging for students. This model has the potential to continue even when institutions are no longer affected by COVID-19.

Curriculum Innovation in Times of the COVID-19 Pandemic: The Thinking-Based Instruction Theory and Its Application

At the beginning of 2020, to stop the spread of the coronavirus disease (COVID-19) to the campus, the Ministry of Education of China launched a policy “Suspension of classes without suspending schooling” for the spring semester of 2020. However, the drawbacks of online teaching (e.g., students’ inadequate autonomous learning, the lack of effective online instruction) forced us to modify teaching strategies during this special period, especially developing courses that are suitable for student learning at home and improving their key competencies. In order to solve these problems, this study introduces some theoretical exploration and practical work of curriculum design under the guidance of thinking-based instruction theory (TBIT) during the pandemic. We firstly introduce TBIT, and elaborate on the curriculum design under the TBIT theoretical frame. Then we describe a series of TBIT-based micro-courses with the pandemic as background. A descriptive study is reported to illustrate the effects of three micro-courses. Results showed that, compared to national curricula, the TBIT-based micro-courses not only improved the course quality but also enhanced students’ motivation and facilitated their online learning behavior (such as interactive communication) for the online courses. The current study has important implications for how to design effective and interesting online courses suitable under pandemic and capable of improving students’ thinking abilities and key competencies.

Effectiveness of an adaptive eLearning intervention on dental students' learning in comparison to traditional instruction

There is a great deal of excitement in higher education about the value of adaptive learning to personalize learning paths according to students' individual needs. The authors explored the impact of an Adaptive Learning Platform (ALP) on learning, by comparing learning effectiveness between dental students who used the ALP in a blended learning environment formatively and summatively compared with students who did not use the ALP (i.e., face-to-face), as measured by students' performance on the final exam in a single review preparatory course during the academic years 2013-2018. Paired t-tests showed significant improvement in post-test scores across different course instructional modalities (P < 0.01). The learning gain was greater for students who studied using the ALP summatively (t = 26.20) than those who used it formatively or studied using a face-to-face format (t = 13.10 and 14.13, respectively). Controlling for pre-test scores, analysis of covariance tests indicate that: (1) intervention groups (formative and summative ALP) scored significantly higher than the traditional group (B = 9.34 points, P < 0.01, for summative ALP group) and (B = 4.47 points, P < 0.05, for formative ALP group), and (2) summative ALP group scored significantly higher than formative ALP group (B = 4.84 points, P < 0.05). This study provides empirical evidence that an adaptive learning intervention can have a significant impact on student learning performance. The success of any adaptive learning system relies mainly on sound instructional design. Technology will continue to grow at an overwhelming pace; the cautionary note the authors highlight is that conceptions of pedagogy, complemented by technology, must guide the development of adaptive learning systems.

Rational emotive intervention for stress management among english education undergraduates: Implications for school curriculum innovation

BACKGROUND/OBJECTIVE

Different studies have shown the prevalence of high level of stress among undergraduate students. The objective of the present study was to investigate the effect of rational emotive behavioral therapy (REBT) as a stress management intervention among English Education undergraduates in Universities in Southeastern Nigeria.

METHOD

The study adopted a group randomized trial design. One hundred sixteen samples of English education undergraduates (with a high level of perceived stress) took part in the study. These students were randomly assigned to groups - intervention group(n = 58) and no-intervention control group (n = 58). The Perceived Stress Scale (PSS-14) was used for data collection. The collected data were analyzed using 2-way mixed repeated measure ANOVA and independent sample t test at 0.05 probability level.

RESULT

Results showed that an REBT program significantly reduced the stress among English education undergraduates in the intervention group compared to the students in the control group as measured by PSS-14. Also, the English education undergraduates who benefited from the REBT program maintained the reduction in stress after 3 months when the researchers conducted a follow-up.

CONCLUSION

REBT program can be used to equip undergraduate students with the necessary skills to manage stress. The implications for curriculum innovation were highlighted.

Intervention for burnout among English education undergraduates: implications for curriculum innovation

BACKGROUND/OBJECTIVE

The present study investigated the effect of Rational Emotive Behavior Therapy (REBT) intervention on burnout among English education undergraduates in southeastern Nigeria.

METHOD

The study adopted a randomized controlled trial design. A total of 96 English education undergraduates with high burnout symptoms in the participating universities took part in the study. These were randomly assigned to groups - intervention group (n = 48) and control group (n = 48). The Oldenburg Burnout Inventory for students (OLBI-S) was used for data collection. The collected data were analyzed using 2-way mixed repeated measure ANOVA at .05 probability level.

RESULT

Results showed that the REBT program significantly reduced the burnout level among English education undergraduates in the intervention group compared to the students in the no-intervention control group as measured by the OLBI-S subscales. Also, the students who benefited from the REBT program maintained reduced burnout levels when the researchers conducted a follow-up.

CONCLUSION

Given the present finding, the REBT program is an effective intervention for preventing and managing burnout among students. The present study has important curriculum innovation implications as far as English education is concerned especially in the Nigerian context. This intervention program can be included in the students' curriculum activities so as to equip the students with necessary therapeutic skills to manage burnout symptoms presently and in the future.

Lean Methods Applied to CAD/CAM Pedagogy in the Dental Simulation Laboratory

Dental education is incorporating computer-assisted design/computer-assisted manufacturing (CAD/CAM) into patient care delivery. The aim of this study was to determine if lean production methods applied to the preclinical phase of dental education would reduce the students' time (efficiency) to complete CAD/CAM indirect restorations (CAD/CAM IR) without compromising the desired quality of the CAD/CAM tooth preparations (effectiveness). In 2016, all third-year students at one U.S. dental school were randomly assigned to control and research groups (approximately 33 per group). The control group was taught using existing methods, while the course was redesigned to incorporate lean methods for the research group. Cycle times of the CAD/CAM IR process for both groups were collected and statistically analyzed to compare the effectiveness of the redesign. Standardized grading forms and tools were used to assess the quality of the CAD/CAM tooth preparations. The research group demonstrated significantly faster preparation times with both crowns and onlays (p<0.05) than the control group. The research group also produced CAD/CAM crown and onlay designs at a significantly faster pace than the control group (p<0.05). There was no significant difference between the control and research groups associated with the scanning process times (p>0.05) nor in the quality of the CAD/CAM tooth preparations (p>0.05). This study demonstrated that lean methods applied to pedagogy significantly decreased preparation and design times in a CAD/CAM restorative dentistry course without compromising the quality of the CAD/CAM tooth preparations.

A Case Study Optimizing Human Resources in Rwanda's First Dental School: Three Innovative Management Tools

Harvard School of Dental Medicine, University of Maryland School of Dentistry, and the University of Rwanda (UR) are collaborating to create Rwanda's first School of Dentistry as part of the Human Resources for Health (HRH) Rwanda initiative that aims to strengthen the health care system of Rwanda. The HRH oral health team developed three management tools to measure progress in systems-strengthening efforts: 1) the road map is an operations plan for the entire dental school and facilitates delivery of the curriculum and management of human and material resources; 2) each HRH U.S. faculty member develops a work plan with targeted deliverables for his or her rotation, which is facilitated with biweekly flash reports that measure progress and keep the faculty member focused on his or her specific deliverables; and 3) the redesigned HRH twinning model, changed from twinning of an HRH faculty member with a single Rwandan faculty member to twinning with multiple Rwandan faculty members based on shared academic interests and goals, has improved efficiency, heightened engagement of the UR dental faculty, and increased the impact of HRH U.S. faculty members. These new tools enable the team to measure its progress toward the collaborative's goals and understand the successes and challenges in moving toward the planned targets. The tools have been valuable instruments in fostering discussion around priorities and deployment of resources as well as in developing strong relationships, enabling two-way exchange of knowledge, and promoting sustainability.

Lessons learned from piloting mHealth informatics practice curriculum into a medical elective

Introduction

This case study reports the development and delivery of an mHealth elective piloted for first-year undergraduate medical students at Monash University (Australia) and the lessons learned by designers.

Results

The students were not as adept at using mHealth devices as the literature had predicted. Expert speakers using mHealth for practice perceptibly engaged students. Force-field analysis was a useful basis for devising end-user evaluative research tools for practice. Combining small- and large-group discussions with eLearning discussions promoted student engagement with new concepts and associated jargon. Assessment by mHealth informatics champions supported the students' independent learning.

Lessons learned

Promotion of mHealth curriculum must be transparent and clear. Our elective delivery was hampered by a lack of suitable mobile device ownership and limited availability of useful, free apps. Technological jargon required clarification. Educators require particular mHealth informatics and educational expertise to support mHealth pedagogies. This learning helps to prepare medical curriculum designers for addressing evolving mHealth practice horizons.

The Flipped Classroom in Emergency Medicine Using Online Videos with Interpolated Questions

BACKGROUND

Utilizing the flipped classroom is an opportunity for a more engaged classroom session. This educational approach is theorized to improve learner engagement and retention and allows for more complex learning during class. No studies to date have been conducted in the postgraduate medical education setting investigating the effects of interactive, interpolated questions in preclassroom online video material.

OBJECTIVES

We created a flipped classroom for core pediatric emergency medicine (PEM) topics using recorded online video lectures for preclassroom material and interactive simulations for the in-classroom session.

METHODS

Lectures were filmed and edited to include integrated questions on an online platform called Zaption. One-half of the residents viewed the lectures uninterrupted (Group A) and the remainder (Group B) viewed with integrated questions (2-6 per 5-15-min segment). Residents were expected to view the lectures prior to in-class time (total viewing time of approximately 2½ h). The 2½-h in-class session included four simulation and three procedure stations, with six PEM faculty available for higher-level management discussion throughout the stations. Total educational time of home preparation and in-class time was approximately 5 h.

RESULTS

Residents performed better on the posttest as compared to the pretest, and their satisfaction was high with this educational innovation. In 2014, performance on the posttest between the two groups was similar. However, in 2015, the group with integrated questions performed better on the posttest.

CONCLUSION

An online format combined with face-to-face interaction is an effective educational model for teaching core PEM topics.

Untangling the Web of Influences on Dental Students' Participation in Interprofessional Education Programs

The aim of this study was to explore how dental students involved in an experiential interprofessional education (IPE) program in New Zealand made sense of engaging in this unfamiliar learning environment. Qualitative data gathered from students during group interviews were analyzed to better understand how they assessed the IPE experience. Interviews were audiorecorded and transcribed before analysis of students' comments was undertaken, using constant comparison analysis and taking an inductive approach to the initial coding. Once each of the investigators had gone through his or her own transcripts, they reviewed each other's coding and agreed-upon categories before applying the 3-P model of student learning. Over a three-year period (2012-14), 16 focus groups were conducted with students from multiple health professions. In total, 24 dental students participated. Six categories of comments made in the focus groups were identified: expectations and realizations; not practicing; trade-offs/losses; learning with, from, and about each other; becoming open to a different clinical experience; valuing dental students' participation in IPE; and learning about what dentists do. From these categories, three main themes emerged: becoming a dentist, negotiating IPE experience, and valuing dentistry. The 3-P model highlighted the complexity of IPE, and the challenges suggested that dental students may need extra preparation prior to participating in IPE programs.

Modern Management Principles Come to the Dental School

The University of Washington School of Dentistry may be the first dental school in the nation to apply lean process management principles as a primary tool to re-engineer its operations and curriculum to produce the dentist of the future. The efficiencies realized through re-engineering will better enable the school to remain competitive and viable as a national leader of dental education. Several task forces conducted rigorous value stream analyses in a highly collaborative environment led by the dean of the school. The four areas undergoing evaluation and re-engineering were organizational infrastructure, organizational processes, curriculum, and clinic operations. The new educational model was derived by thoroughly analyzing the current state of dental education in order to design and achieve the closest possible ideal state. As well, the school's goal was to create a lean, sustainable operational model. This model aims to ensure continued excellence in restorative dental instruction and to serve as a blueprint for other public dental schools seeking financial stability in this era of shrinking state support and rising costs.

Influence of national culture on the adoption of integrated medical curricula

Integrated curricula have been implemented in medical schools all over the world. However, among countries different relative numbers of schools with integrated curricula are found. This study aims to explore the possible correlation between the percentage of medical schools with integrated curricula in a country and that country's cultural characteristics. Curricula were defined as not integrated if in the first 2 years of the program at least two out of the three monodisciplinary courses Anatomy, Physiology and Biochemistry were identified. Culture was defined using Hofstede's dimensions Power distance, Uncertainty avoidance, Masculinity/Femininity, and Individualism/Collectivism. Consequently, this study had to be restricted to the 63 countries included in Hofstede's studies which harbored 1,195 medical schools. From each country we randomly sampled a maximum of 15 schools yielding 484 schools to be investigated. In total 91% (446) of the curricula were found. Correlation of percent integrated curricula and each dimension of culture was determined by calculating Spearman's Rho. A high score on the Power distance index and a high score on the Uncertainty avoidance index correlated with a low percent integrated curricula; a high score on the Individualism index correlated with a high percent integrated curricula. The percentage integrated curricula in a country did not correlate with its score on the Masculinity index. National culture is associated with the propensity of medical schools to adopt integrated medical curricula. Consequently, medical schools considering introduction of integrated and problem-based medical curricula should take into account dimensions of national culture which may hinder the innovation process.