Evaluating the efficacy of Vertical Integration in training undergraduate medical students under Competency Based Medical Education Curriculum

Background: The National Medical Council in the Indian Medical Graduate guidelines to enhance learning, recommends Vertical and Horizontal Integration. Vertical integration may be defined as a curricular strategy that aligns para-clinical and clinical teaching across time with a view to enhancing relevance and application of knowledge. The present study is an attempt to test whether vertical integration of Forensic Medicine and Psychiatry is associated with greater short-term learning gains and improved student perceptions compared with conventional didactic lectures. Methods: With Institutional and Ethics Committee clearance, a two-phase quasi-experimental study was performed across two consecutive academic cohorts (Phase 1, 2024; Phase 2, 2025) of MBBS Phase-3 students at a tertiary medical college in South India. Phase-1 students (conventional format, n = 160) received sequential discipline-specific lectures; Phase-2 students (vertical integration, n = 156) received a co-delivered integrated session covering the same topic (“Civil and Criminal Responsibility of the Mentally Ill”). A pilot-tested, expert-validated 18-item MCQ questionnaire (pilot n = 25; pilot Cronbach’s α = 0.78) and a 5-item Likert feedback questionnaire were administered pre- and post-session. Tests were scored 1 = correct, 0 = incorrect (total out of 18). Paired pre–post changes were assessed by Wilcoxon signed-rank test; item changes were tested by McNemar’s test. Internal consistency for study data was computed (Cronbach’s α). Significance threshold p < 0.05. Results: The statistical analysis showed a mean gain of +4.95 in knowledge and performance of the group exposed to conventional teaching methodology and a mean gain of +6.52 in the group exposed to integrated teaching methodology. Both the gains were statistically significant. The integrated session produced a greater mean gain than conventional format (difference in mean gains = 1.57 points). Item-level McNemar testing identified significant post-session gains in 9 of 18 items following integration (notably Q3, Q5, Q9, Q11, Q13, Q17, Q18). 85.6% of the students preferred the integrated session. Conclusions: Vertical integration of Forensic Medicine and Psychiatry resulted in significantly higher short-term learning gains and was strongly favored by students. Implementation of shared, case-based integrated teaching is recommended within CBME to enhance applied learning and student engagement.