The application of interdisciplinary integrated teaching in rheumatoid arthritis (RA) medical education

Interdisciplinary Integrated Teaching is based on constructivist learning theory, systems theory, and collaborative learning theory, emphasising the comprehensive nature of knowledge and its contextual application. Constructivism holds that learning is a process of constructing personal cognition through the integration of knowledge from different fields, while systems theory emphasises that the diagnosis and treatment of complex diseases such as RA require a multidisciplinary collaborative perspective. Collaborative learning theory supports the cultivation of students’ comprehensive abilities and problem-solving skills through teamwork. RA is a chronic, systemic autoimmune disease involving multiple organ systems and complex management strategies. Interdisciplinary integrated teaching integrates disciplines such as rheumatology and immunology, imaging, and pharmacy to help students understand the pathophysiological mechanisms, diagnostic criteria, treatment protocols, and patient management of RA, thereby enhancing their ability to address complex diseases.

References

Ross P M, Mercer-Mapstone L, Pozza L E, et al, 2022, An idea to explore: Interdisciplinary capstone courses in biomedical and life science education. Biochem Mol Biol Educ, 50(6): 649-60.

Granger E M, Bevis T H, Saka Y, et al, 2012, The efficacy of student-centered instruction in supporting science learning. Science, 338(6103): 105-8.

James M, Baptista A M T, Barnabas D, et al, 2022, Collaborative case-based learning with programmatic team-based assessment: A novel methodology for developing advanced skills in early-years medical students. BMC Med Educ, 22(1): 81.

Champagne-Langabeer T, Revere L, Tankimovich M, et al, 2019, Integrating diverse disciplines to enhance interprofessional competency in healthcare delivery. Healthcare (Basel), 7(2): 75-85.

Boon M, van Baalen S, Groenier M, 2019, Interdisciplinary expertise in medical practice: Challenges of using and producing knowledge in complex problem-solving. Med Teach, 41(6): 668-77.

Mitchell R, Boyle B, O'Brien R, et al, 2017, Balancing cognitive diversity and mutual understanding in multidisciplinary teams. Health Care Manage Rev, 42(1): 42-52.

Macleod A, Luong V, Cameron P, et al, 2023, Case-informed learning in medical education: A call for ontological fidelity. Perspect Med Educ, 2(1): 120-8.

Koufidis C, Manninen K, Nieminen J, et al, 2020, Grounding judgement in context: A conceptual learning model of clinical reasoning. Med Educ, 54(11): 1019-28.

Qiu K, Zeng T, Xia W, et al, 2025, Interdisciplinary medical education practices: Building a case-driven interdisciplinary simulation system based on public datasets. BMC Med Educ, 25(1): 1037.

Wen F, Mo J, Li R, 2024, Application value of multi-disciplinary collaborative diagnosis and treatment combined with CBL teaching model in gynecological oncology practice teaching. Front Med (Lausanne), 11: 1468256.

Nayak K R, Nayak V, Punja D, et al, 2023, Simulated patient videos to supplement integrated teaching in competency-based undergraduate medical curriculum. Adv Physiol Educ, 47(2): 296-306.

Peacock J G, Grande J P, 2015, Patient exposure in the basic science classroom enhances differential diagnosis formation and clinical decision-making. PeerJ, 3: e809.

Nuruzzaman F, Lu W H, Dechello K, et al, 2025, Development and implementation of a multidisciplinary translational course using rheumatoid arthritis as a model for chronic illness during the medical student clerkship year. Med Sci Educ, 35(1): 47-50.

Yang B H, Lo K W, Li Y S, et al, 2024, Effects of integration interdisciplinary learning on student learning outcomes and healthcare-giving competence: A mixed methods study. BMC Nurs, 23(1): 583.

Umstattd Meyer M R, Prochnow T, Hess B, et al, 2025, Fostering collaborative practice through interprofessional education. Fam Med, 57(2): 91-7.

Sung T C, Hsu H C, 2025, Improving critical care teamwork: Simulation-based interprofessional training for enhanced communication and safety. J Multidiscip Healthc, 18: 355-67.

Yang P, Xiong T, Dong X, et al, 2025, Interprofessional teaching rounds in medical education: Improving clinical problem-solving ability and interprofessional collaboration skills. Med Educ Online, 30(1): 2451269.

Williams K N, Lazzara E H, Hernandez J, et al, 2024, Integrating competency-based, interprofessional teamwork education for students: Guiding principles to support current needs and future directions. Front Med (Lausanne), 11: 1490282.

Hamoen E C, van Blankenstein F M, de Jong P G M, et al, 2021, Development of a clinical teaching unit in internal medicine to promote interprofessional and multidisciplinary learning: A practical intervention. Teach Learn Med, 33(1): 78-88.

Holmdahl R, Malmström V, Burkhardt H, 2014, Autoimmune priming, tissue attack and chronic inflammation - the three stages of rheumatoid arthritis. Eur J Immunol, 44(6): 1593-9.

Catrina A I, Svensson C I, Malmström V, et al, 2017, Mechanisms leading from systemic autoimmunity to joint-specific disease in rheumatoid arthritis. Nat Rev Rheumatol, 13(2): 79-86.

Manolis A S, Tzioufas A G, 2020, Cardio-rheumatology: Cardiovascular complications in systemic autoimmune rheumatic diseases / is inflammation the common link and target? Curr Vasc Pharmacol, 18(5): 425-30.

Rizzello F, Olivieri I, Armuzzi A, et al, 2018, Multidisciplinary management of spondyloarthritis-related immune-mediated inflammatory disease. Adv Ther, 35(4): 545-62.

Biciusca V, Rosu A, Stan S I, et al, 2024, A practical multidisciplinary approach to identifying interstitial lung disease in systemic autoimmune rheumatic diseases: A clinician's narrative review. Diagnostics (Basel), 14(23): 2736.

Hasseli R, Pfeiffer S, Kappesser J, et al, 2020, Model project on interdisciplinary university teaching-medical and psychology students learn together for the first time. Z Rheumatol, 79(2): 200-2.

Sharpe L, 2016, Psychosocial management of chronic pain in patients with rheumatoid arthritis: Challenges and solutions. J Pain Res, 9: 137-46.

Faller H, Reusch A, Meng K, 2011, Innovative concepts for patient education in medical rehabilitation. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 54(4): 444-50.

Feng P, Wu J, Jin Z, et al, 2024, Effect evaluation of competency-based education (CBE) combined with multi-disciplinary team (MDT) teaching mode in respiratory rehabilitation nursing teaching: A randomized controlled trial. Nurse Educ Pract, 76: 103896.

Bartlett S J, de Leon E, Orbai A M, et al, 2020, Patient-reported outcomes in RA care improve patient communication, decision-making, satisfaction and confidence: Qualitative results. Rheumatology (Oxford), 59(7): 1662-70.

Pablos J L, Cañete J D, 2013, Immunopathology of rheumatoid arthritis. Curr Top Med Chem, 13(6): 705-11.

Baerwald C, Kneitz C, Bach M, et al, 2012, Extra-articular manifestations of rheumatoid arthritis. Z Rheumatol, 71(10): 841-9.

Chiu W C, Lai H M, Ko C H, et al, 2018, Ultrasound is more reliable than inflammatory parameters to evaluate disease activity in patients with RA receiving tocilizumab therapy. J Investig Med, 66(6): 1015-8.

Hama M, Uehara T, Takase K, et al, 2012, Power Doppler ultrasonography is useful for assessing disease activity and predicting joint destruction in rheumatoid arthritis patients receiving tocilizumab--preliminary data. Rheumatol Int, 32(5): 1327-33.

Suto T, Okamura K, Yonemoto Y, et al, 2016, Prediction of large joint destruction in patients with rheumatoid arthritis using 18F-FDG PET/CT and disease activity score. Medicine (Baltimore), 95(7): e2841.

Negrei C, Bojinca V, Balanescu A, et al, 2016, Management of rheumatoid arthritis: Impact and risks of various therapeutic approaches. Exp Ther Med, 11(4): 1177-83.

Teh J, Østergaard M, 2017, What the rheumatologist is looking for and what the radiologist should know in imaging for rheumatoid arthritis. Radiol Clin North Am, 55(5): 905-16.

Llopis E, Kroon H M, Acosta J, et al, 2017, Conventional radiology in rheumatoid arthritis. Radiol Clin North Am, 55(5): 917-41.

Arrigoni F, Daffinà J, Barile A, 2024, Current role of conventional radiology in rheumatology. Radiol Clin North Am, 62(5): 799-807.

Tins B J, Butler R, 2013, Imaging in rheumatology: Reconciling radiology and rheumatology. Insights Imaging, 4(6): 799-810.

Østergaard M, 2012, Can imaging be used for inflammatory arthritis screening? Semin Musculoskelet Radiol, 16(5): 401-9.

Rahmani M, Chegini H, Najafizadeh S R, et al, 2010, Detection of bone erosion in early rheumatoid arthritis: Ultrasonography and conventional radiography versus non-contrast magnetic resonance imaging. Clin Rheumatol, 29(8): 883-91.

Tang H, Qu X, Yue B, 2020, Diagnostic test accuracy of magnetic resonance imaging and ultrasound for detecting bone erosion in patients with rheumatoid arthritis. Clin Rheumatol, 39(4): 1283-93.

Hammer H B, Terslev L, 2012, Role of ultrasound in managing rheumatoid arthritis. Curr Rheumatol Rep, 14(5): 438-44.

Cen Y, He D, Wang P, et al, 2024, Contribution of musculoskeletal ultrasound in the diagnosis of seronegative rheumatoid arthritis. J Ultrasound Med, 43(10): 1929-36.

Krabben A, Stomp W, van Nies J A, et al, 2014, MRI-detected subclinical joint inflammation is associated with radiographic progression. Ann Rheum Dis, 73(11): 2034-7.

Kuettel D, Glinatsi D, Østergaard M, et al, 2020, Serial magnetic resonance imaging and ultrasound examinations demonstrate differential inflammatory lesion patterns in soft tissue and bone upon patient-reported flares in rheumatoid arthritis. Arthritis Res Ther, 22(1): 19.

Kondo Y, Kaneko Y, Sugiura H, et al, 2017, Pre-treatment interleukin-6 levels strongly affect bone erosion progression and repair detected by magnetic resonance imaging in rheumatoid arthritis patients. Rheumatology (Oxford), 56(7): 1089-94.

Forslind K, Svensson B, 2016, MRI evidence of persistent joint inflammation and progressive joint damage despite clinical remission during treatment of early rheumatoid arthritis. Scand J Rheumatol, 45(2): 99-102.

Tse J J, Brunet S C, Salat P, et al, 2020, Multi-modal imaging to assess the interaction between inflammation and bone damage progression in inflammatory arthritis. Front Med (Lausanne), 7: 545097.

Reijnierse M, Helm-Mil A V, Eshed I, et al, 2018, Magnetic resonance imaging of rheumatoid arthritis: Peripheral joints and spine. Semin Musculoskelet Radiol, 22(2): 127-46.

Ather S, Naeem A, Teh J, 2024, Imaging response to treatment in rheumatology. Radiol Clin North Am, 62(5): 877-88.

Albano D, Carubbi F, 2021, Advancing frontiers in rheumatic and musculoskeletal imaging. BMC Musculoskelet Disord, 22(1): 227.

Filippoucci E, Di Geso L, Grassi W, 2014, Progress in imaging in rheumatology. Nat Rev Rheumatol, 10(10): 628-34.

Mohana-Borges A V R, Chung C B, 2023, Imaging of rheumatic diseases affecting the lower limb. Radiol Clin North Am, 61(2): 345-60.

Benucci M, Grossi V, Manfredi M, et al, 2020, Laboratory monitoring of biological therapies in rheumatology: The role of immunogenicity. Ann Lab Med, 40(2): 101-13.

Vandebeek D, Lodewijckx E, van Hoovels L, et al, 2025, Integrating pretest probability for rheumatoid arthritis with likelihood ratios of RF and ACPA to improve clinical utility of rheumatoid arthritis autoantibody testing. Clin Chim Acta, 564: 119928.

Gadeholt O, Arnold E, Gorman C, et al, 2024, Body mass index stratification enables cytokine-based prediction of ACPA status and Power-Doppler disease activity in rheumatoid arthritis. Clin Rheumatol, 43(8): 2445-52.

Sejersen K, Weitoft T, Knight A, et al, 2025, Serum calprotectin correlates stronger with inflammation and disease activity in ACPA positive than ACPA negative rheumatoid arthritis. Rheumatology (Oxford), 64(1): 126-32.

Yee A, Webb T, Seaman A, et al, 2015, Anti-CarP antibodies as promising marker to measure joint damage and disease activity in patients with rheumatoid arthritis. Immunol Res, 61(1-2): 24-30.

Min K, Beom J, Kim B R, et al, 2021, Clinical practice guideline for postoperative rehabilitation in older patients with hip fractures. Ann Rehabil Med, 45(3): 225-59.

Guo J, Zhao X, Xu C, 2022, Effects of a continuous nursing care model on elderly patients with total hip arthroplasty: A randomized controlled trial. Aging Clin Exp Res, 34(7): 1603-11.

Ning M, Chen F, Zheng H, et al, 2021, Use of head and neck magnetic resonance angiography to explore neurological function recovery and impact of rehabilitation nursing on patients with acute stroke. World Neurosurg, 149: 470-80.

Zheng G, Cai X, Zhu R, et al, 2021, Effect of holistic rehabilitation nursing on postoperative neurological function recovery and limb function improvement in patients with intraintracerebral hemorrhage. Am J Transl Res, 13(6): 7256-62.

Fang Z, Wu T, Lv M, et al, 2022, Effect of traditional plus virtual reality rehabilitation on prognosis of stroke survivors: A systematic review and meta-analysis of randomized controlled trials. Am J Phys Med Rehabil, 101(3): 217-28.

Nasb M, Shah S Z A, Chen H, et al, 2021, Constraint-induced movement therapy combined with botulinum toxin for post-stroke spasticity: A systematic review and meta-analysis. Cureus, 13(9): e17645.

Yoshihara H, Yoneoka D, Margalit A, et al, 2016, Rheumatoid arthritis patients undergoing total hip and knee arthroplasty have better in-hospital outcomes compared with non-rheumatoid arthritis patients. Clin Exp Rheumatol, 34(2): 270-5.

Clement N D, Breusch S J, Biant L C, 2012, Lower limb joint replacement in rheumatoid arthritis. J Orthop Surg Res, 7: 27.

Wolfe J, Wolfe J, Visser H J, 2019, Perioperative management of the rheumatoid patient. Clin Podiatr Med Surg, 36(1): 115-30.

Widdifield J, Moura C S, Wang Y, et al, 2016, The longterm effect of early intensive treatment of seniors with rheumatoid arthritis: A comparison of 2 population-based cohort studies on time to joint replacement surgery. J Rheumatol, 43(5): 861-8.

Yeganeh M H, Kheir M M, Shahi A, et al, 2018, Rheumatoid arthritis, disease modifying agents, and periprosthetic joint infection: What does a joint surgeon need to know? J Arthroplasty, 33(4): 1258-64.

Rehart S, Schickedanz O, Wickler B, 2025, Infections during joint replacement under immunomodulatory treatment. Z Rheumatol, 84(4): 295-301.

Yeoh S A, Fox C, Hull R, 2016, Neutropenia in the elderly: A rheumatology perspective. Drugs Aging, 33(8): 585-601.

Ren H, Jiang L, Zhou Y, et al, 2025, Effects of nutrition management combined with specialized nursing on nutritional status, immune function and wound healing after joint replacement. Pak J Med Sci, 41(4): 1110-5.

Thomas L, Hadfield N, Munt R, 2024, Patient experience during their joint replacement journey: The role of the orthopaedic nurse practitioner. Int J Orthop Trauma Nurs, 54: 101106.

Bai X, Wang Q, Cao S, 2021, Application of infusion control system based on internet of things technology in joint orthopedics nursing work. J Healthc Eng, 2021: 6691258.

Lwin M N, Serhal L, Holroyd C, et al, 2020, Rheumatoid arthritis: The impact of mental health on disease: A narrative review. Rheumatol Ther, 7(3): 457-71.

Germain V, Scherlinger M, Barnetche T, et al, 2021, Role of stress in the development of rheumatoid arthritis: A case-control study. Rheumatology (Oxford), 60(2): 629-37.

Cole C L, Waterman S, Hunter E C M, et al, 2021, Effectiveness of small group cognitive behavioural therapy for anxiety and depression in Ebola treatment centre staff in Sierra Leone. Int Rev Psychiatry, 33(1-2): 189-97.

Tosato S, Bonetto C, Zanini A, et al, 2023, Coping strategies, emotional distress and perceived disease severity in a cohort of patients with rheumatoid arthritis: A mediation analysis. Rheumatology (Oxford), 62(3): 1078-86.

Previous article in this issue

Next article in this issue