ArticlePakistan journal of medical sciences2026
Optimizing Curriculum Integration: Development and Validation of the Tool of Integration Practices (TIP) in Health Professions Education - A Mixed Methods Study.
Article in Pakistan journal of medical sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Curriculum integration is increasingly adopted in medical and dental education, yet only a few validated tools exist to measure it objectively. Existing curriculum integration frameworks, including Harden's ladder, are primarily descriptive and challenging to apply for systematic evaluation. Therefore, this study aimed to develop a valid and reliable tool to assess the level of integration in medical and dental curricula. Methodology: A multiphase mixed-method approach was employed over nine months from July 2023 to March 2024 at Riphah International University, Pakistan. Literature review identified eight domains representing curriculum integration, each structured on a five-point scale informed by Harden's integration ladder. Content validity was established through expert reviews (n = 17), followed by cognitive interviews with faculty (n = 6) to obtain response process validity. Medical and dental faculty (n = 150) participated in pilot testing. Internal structure validity evidence was evaluated by Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Reliability was assessed using Cronbach's alpha. Results: Content validation yielded a seven-domain instrument with a mean content validity index of 0.89 and an average content clarity score of 3.46. Cognitive interviews led to minor revisions in four items. The final tool demonstrated good reliability (Cronbach's alpha = 0.88). EFA supported a one-factor model, confirmed by CFA (GFI = 0.96, RMSEA = 0.052, normed χ² = 1.4), indicating a good model fit. Conclusion: The Tool of Integration Practices (TIP) demonstrated adequate validity and reliability. It provides a practical, psychometrically sound framework for assessing and comparing curriculum integration practices based on faculty perceptions at the course and program levels in health professions education.
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