How Fink’s Taxonomy Can Improve Your Curriculum Part Four: Integration

By: Danielle T. Miller MD

In the previous post So You Have Been Inspired to Make a Curriculum, But Is Your Curriculum Inspiring? I provided an introduction to Fink’s Taxonomy of Learning.  L. Dee Fink proposed that learning only occurs when there is change, or what he refers to as “significant learning.”  Significant learning occurs at the center of six domains of learning:

  1. Foundational Knowledge
  2. Application
  3. Integration
  4. Human Dimension
  5. Caring
  6. Learning to Learn

This post will discuss Integration and how to incorporate this domain into a curriculum. Let’s return again to our case.

The Case:

You’ve been inspired to make a curriculum on diabetes management for medical students in their pre-clinical years. You would like to incorporate all six domains of Fink’s Taxonomy of Learning into the curriculum for your medical students to achieve significant learning. Today you are focusing on incorporating Integration into your curriculum. 

What is Integration?

Integration is the domain in which learners connect concepts and ideas. Integration also involves the ability of learners to connect people and perspectives. An example of a learner using integration is, when evaluating a patient with hyperosmolar hyperglycemic state (HHS), the student not only makes the diagnosis but remembers that HHS occurs often due to infection or medication non-compliance and incorporates these questions into her history taking and consideration in her work-up. Integration also involves interdisciplinary learning. For instance, arranging a panel of pediatric intensivists, pediatric endocrinologists, pharmacists, and child life specialists to discuss the topic of new diagnosis of type I diabetes and management, would be an example of Integration in a curriculum.

What questions can help formulate Integration learning goals and objectives for a curriculum?

The general learning goal for students in this domain is:

  • By the end of this course, students should be able to relate the subject matter to other subjects and perspectives.

To aid in designing specific learning objectives for a curriculum, here are some questions that generate Integration learning objectives: 

  • What connections should students realize at the end of this course?
  • What teams should students seek information and perspectives by the end of this course?

What are the types of learning strategies that incorporate Integration into a curriculum?

There are many different learning strategies that can be used for Integration including:

  • Cross-disciplinary teams and panels
  • Simulation: individual or with teams
  • Cases: individual, small group, large group
  • Reflection exercises
  • Concept Mapping

Consider incorporating learner driven projects to allow for Integration. Also consider incorporating adequate reflection opportunities to allow for learners to exercise Integration skills. 

Conclusion

Integration is one of six learning domains in Fink’s Taxonomy. These learning domains are interactive. By incorporating all six domains into a curriculum, learners can experience significant and lasting learning. The next post will discuss the learning domain Human Dimension. 

Learn More

Biography of L. Dee Fink http://finkconsulting.info/
Full Text of Creating Significant Learning Experiences https://www.unl.edu/philosophy/%5BL._Dee_Fink%5D_Creating_Significant_Learning_Experi(BookZZ.org).pdf  
Information about Learning Taxonomies Peak Performance Center. http://thepeakperformancecenter.com/educational-learning/thinking/blooms-taxonomy/learning-taxonomies/   St Emlyn’s Emergency Medicine https://www.stemlynsblog.org/better-learning/educational-theories-you-must-know-st-emlyns/educational-theories-you-must-know-millers-pyramid-st-emlyns/  
Application of Fink’s Taxonomy to Medical Education Jeremy Branzetti, Michael A. Gisondi, Laura R. Hopson & Linda Regan (2019) Aiming Beyond Competent: The Application of the Taxonomy of Significant Learning to Medical Education, Teaching and Learning in Medicine, 31:4, 466-478, DOI: 10.1080/10401334.2018.1561368