Abstract:

Clinical Immunology is a relatively small and new clinical speciality within Ireland, but an understanding of basic and clinical immunology is highly relevant across all medical and surgical subspecialties.

Whilst the importance of immunology may be obvious in the fields of Allergy, Immunodeficiency and Transplant Medicine, an understanding of immunology is essential across all organ systems to understand the pathophysiology, diagnosis and management of disease- including infection, inflammation, autoimmunity and cancer.

Knowledge of Immunology is becomingly increasingly important with a rising prevalence of allergic disease now affecting 10% of the world’s population, and 50% of young people in developed countries. Biologicals, particularly synthetic antibodies and other immune-related medications, accounted for a third of new FDA drugs approved in 2019, while drug allergy is a major cause of preventable patient harm; and vaccines mark one of the greatest advances in Public Health globally.

In our current traditional medical curriculum, Immunology has been taught through didactic lectures with other Basic Sciences in “pre-clinical years” after students have had an introduction to Basic Cell Biology and Physiology, and immunology is not clearly visible in the later clinical years.

With the local introduction of a new spiralled curriculum in 2022, immunology is due to be condensed, introduced from as early as the 2nd week of Year 1, and then horizontally and vertically integrated throughout the curriculum along with other Basic Sciences, according to the principles of the Spiral Curriculum.

Teaching immunology in a new curricular structure, to students with immense cultural and experiential diversity, and potentially limited foundations of knowledge in cell biology or physiology, brings both challenges and opportunities, which will be amplified by the new COVID-19 environment.

With any curricular change, it is important that the content, sequence, and learning methods are carefully considered to ensure that is fit for purpose, for both the students and staff involved.

As immunology is relevant across all clinical specialities and organ systems it offers many opportunities for integration, however the best method to approach this is not clear.

Here we describe the steps we have taken in planning to integrate immunology into our new spiralled curriculum, which could be replicated elsewhere for other subjects. We report the main outcomes from our consultation and consensus methods involving multiple stakeholders and discuss key learnings from our experience.

We explain how we harnessed valuable opinions from both staff and international alumni, representing multiple disciplines, by combining different survey methods before and after a consensus development panel to gather evidence, refine any proposals and validate our conclusions.

Keywords:

Immunology, spiral, consensus development panel, curriculum design, case based learning.