Developed using cognitive behavioral research to improve learning accessibility, the use of a spiral curriculum helps educators organize the content and the overall structure of a topic. Let’s learn more about what a spiral curriculum is and discuss the benefits of using it in healthcare education.
Introduction: What is a Spiral Curriculum?
American psychologist and researcher Jerome Bruner believed nothing is too complicated to learn if it’s structured properly. To that end, Bruner introduced a new learning theory called a spiral curriculum in his book, The Process of Education, in 1960. Sometimes referred to as “spaced learning,” a spiral curriculum is best explained by its three guiding principles:
- Cyclical learning: A student revisits the same topic multiple times using different learning methods.
- Increasing depth: The complexity of the topic increases with each revisit, adding layers of information each time.
- Learning by building on prior knowledge: New topics are put into the context of the topic, ensuring that nothing exists in isolation.
Rooted in cognitive behavioral educational theory (which focuses on the notion that how we think, feel, and act affects how we learn), the core concept of a spiral curriculum is that we learn best when it’s done by gently increasing complexity over time. Think of a child learning to speak; they may start with just one syllable that gets repeated until it slowly grows into proper words and fully formed sentences. So, instead of providing a constant stream of new information, educators “loop back” to concepts and knowledge students have already been exposed to in class or learning materials.
The Advantages of a Spiral Curriculum for Healthcare Education
While there are a variety of studying styles, a spiral curriculum offers advantages for just about anyone pursuing a healthcare education. Let’s dive into the benefits!
Reinforcement of Fundamental Concepts
All medical, nursing, and healthcare students must develop a solid foundation of knowledge in physiology and pathology. A spiral curriculum reinforces that learning by frequently revisiting topics so that students can fortify fundamental concepts in their memory.
Much like the benefits of using active recall to identify and bridge learning gaps, a spiral curriculum requires students to remember what they’ve learned. Using a spiral curriculum ensures that every time a learner is faced with a new topic, they’re also asked to take into consideration what they’ve already learned to help reinforce a connection between the new and existing knowledge.
Integrating Knowledge Using a Spiral Curriculum
One of the most difficult aspects of healthcare education is that all the information is interconnected. Nothing occurs in isolation, so why should it be taught that way? A “spiraling” curriculum allows students to practice making connections and integrate existing knowledge with new information by constantly relating what they’re learning to what’s come before.
Don’t be fooled by the fact that a spiral curriculum revisits material; it doesn’t mean it isn’t forcing students to build cognitive skills. In fact, by building complexity over time and requiring learners to connect multiple pieces of information, they develop critical thinking and problem-solving skills.
It’s also worth noting that this approach is less overwhelming for students as it eases them into each new learning loop by flagging familiar concepts. New information is much easier to digest when our brains link it to something we’ve already mastered.
Preparation for Lifelong Learning Using a Spiral Curriculum
As any medical professional knows, learning in the field never stops. New scientific discoveries and experiences as a clinician will constantly force them to build on the complexity of their knowledge. A spiral curriculum mimics that process and, as such, helps medical, nursing, and healthcare students integrate continuous learning into their professional lives.

The Challenges of Using Spiral Curriculum in Healthcare Education
For all its advantages, implementing a spiral curriculum in healthcare education is a challenging task. Some of the issues that make applying Bruner’s approach difficult include curriculum development and implementation, time constraints, and challenges with assessment.
Curriculum Development and Implementation
Adjusting from a more linear learning model to a spiral curriculum requires significant effort. One of the big obstacles is that a spiral curriculum requires a sense of fluidity between courses and departments to function at its best, which can be challenging.
Time Constraints
The idea that complex concepts should be learned over time is fundamental to a spiral curriculum. Still, time is something that medical, nursing, and other healthcare students have in short supply. If anything, traditional healthcare education models have historically depended on students learning their respective crafts in very short timeframes rather than embracing the benefits of long-term learning.
Assessment Challenges
Traditionally, a topic is taught over a set period and then tested at the end. The spiral curriculum challenges this assessment model because it extends the time it takes to cover subjects and can make it difficult to determine when to test.
Best Practices for the Successful Implementation of Spiral Curriculum
To get it right, implementing a spiral curriculum in a healthcare education program needs to make the following tasks a priority:
Curriculum Planning and Development
Planning is paramount when developing a spiraling curriculum. Since complexity is built over time and adequate attention needs to be given to revisiting past material, the curriculum requires a very clear structure to be effective. If too long a break occurs between revisiting topics or information isn’t designed to be taught gradually enough, it could disrupt the advantages of the learning model.
Integration of Clinical Experiences
One aspect of Bruner’s spiral learning model is that conceptual knowledge exists alongside practical application. This concept works brilliantly for healthcare education, where clinical experience is vital to learning. Instead of treating clinical work as a separate entity, a spiral curriculum is best put into practice when the doing and the thinking are well-integrated.
Ongoing Faculty Development and Support
Any change to the learning process needs to be done with adequate, ongoing support so that neither students nor educators are left adrift. The traditional healthcare education model has often been about dumping large volumes of information on students and expecting them to cope, so switching to a spiral curriculum requires a significant mindset shift and a practical plan.
Assessment and Evaluation
Since a spiral curriculum approaches learning as a constant process, regular assessments are necessary. That may sound like it has the potential to be chaotic, but all it means is that students should be evaluated on both recent learnings and previously learned material.
Essays and case discussions encourage this learning process better than exams but can be used alongside traditional tests and quizzes. The important thing is that students aren’t simply tested on their ability to memorize facts but on how well they can contextualize new topics with established knowledge.
Conclusion
Bruner’s spiral curriculum learning model offers many advantages. Presenting knowledge as a continuously evolving mechanism helps students revisit fundamental concepts while also allowing them to practice a learning process that more accurately reflects life as a doctor, nurse, or other healthcare professional in the field. The key is to invest the necessary time in the planning, development, and assessment to ensure that the spiraling curriculum operates as intended.
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