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Introduction
In planning a curriculum there are many questions to be answered (Harden, 1986). Much attention has been paid to aims and objectives, the content of the curriculum, teaching methods, assessment, and educational strategies such as problem-based learning, integration and community-based learning. A relatively neglected area has been the question of the organization of the content and the overall structure of the curriculum. A traditional view of the curriculum is of a series of courses, each with its own programme and assessment. There is a growing tendency, however, to break down barriers or boundaries between courses and departments and to look at the overall aims or objectives of the curriculum. It is in this context that the concept of a spiral curriculum has particular relevance.
The concept of a spiral curriculum
A spiral curriculum is one in which there is an iterative revisiting of topics, subjects or themes throughout the course. A spiral curriculum is not simply the repetition of a topic taught. It requires also the deepening of it, with each successive encounter building on the previous one. This concept was described first by Jerome Bruner in 1960:
I was struck by the fact that successful efforts to teach highly structured bodies of knowledge like mathematics, physical sciences, and even the field of history often took the form of a metamorphic spiral in which at some simple level a set of ideas or operations were introduced in a rather intuitive way and, once mastered in that spirit, were then revisited and reconstrued in a more formal or operational way, then being connected with other knowledge, the mastery at this stage then being carried one step higher to a new level of formal or operational rigour and to a broader level of abstraction and comprehensiveness. The end state of this process was eventual mastery of the connexity and structure of a large body of knowledge ....
The following are the features of a spiral curriculum:
(1) Topics are revisited: Students revisit topics, themes or subjects on a number of occasions during a course. They may return to a body system, such as the cardiovascular system or the respiratory system. They may revisit themes, such as clinical skills, or medical ethics. They...