Development Strategies in Medical Education

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Mahdavifard H. Spiral Curriculum: A new approach to integration and continuity of learning. DSME 2026; 13 (2) :111-118
URL: http://dsme.hums.ac.ir/article-1-572-en.html

Dear Editor

Today’s medical education system faces unprecedented challenges: an exponential accumulation of knowledge, increasing complexity in clinical decision-making, and an urgent need to train physicians who possess not only a strong memory but also the ability to analyze, synthesize, and apply knowledge in real-world settings. Nevertheless, many current curricula remain anchored in linear and compartmentalized models, wherein basic sciences, pathology, diagnosis, and treatment are taught separately and often with considerable time gaps. In the current model, students learn foundational concepts intensively in the early years and subsequently encounter concepts in clinical phases that bear no clear connection to those foundations. This disconnect renders the reconstruction of knowledge in clinical contexts difficult. This structure not only creates a clear disconnection between theoretical learning and clinical practice but also leads to rapid forgetting and an inability to reconstruct knowledge in new contexts.
In this regard, the spiral curriculum approach, first introduced by Harden and Stamper in 1999, has emerged as a transformative paradigm in medical curriculum design. In a spiral curriculum, core topics and fundamental concepts of each domain are not confined to a limited time frame; rather, they are distributed repetitively throughout the entire course of study, with a gradual increase in difficulty....