Curriculum integration: From Ladder to Ludo
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Updated: Jan 1, 2026

A Training Program Using an Agility Ladder for Community-Dwelling Older Adults
Published on: March 7, 2020
Ahsan Sethi1,2, Rehan Ahmed Khan3
1Institute of Health Professions Education and Research, Khyber Medical University, Peshawar, Pakistan.
Abstract:
This Personal View is based on our experiences with the levels of integration. We are concerned about the (mis) interpretation of 'integration ladder' in our context and propose directions for rethinking curriculum integration. We share the famous board game 'Ludo' as a metaphor to understand the concept of integration. Mughal emperors (educators) played (lead) Ludo (curriculum/teaching reforms) in which tokens (disciplines) move from their silos (departments) towards others (integrate) according to rolls of a dice (resources) and not stepwise (1-2-3…11) like in a ladder. There are safe spaces (timetable/minimum hours), double pieces (combination of different integration levels) and tokens (disciplines) can also be pushed back to their silos by opponents (challenges). The game (change management) involves skill (competence in medical education), strategy (planning), emotion (emotional intelligence) and luck. We found Ludo relevant to understanding integration and discuss three different systems with implications on the curriculum, assessment, organisational structure and timetable/schedules. We believe that a clear description of integration as three different systems will counter the issues with the integration ladder and make it easier for institutions and educationists to understand, opt for and implement curriculum integration.
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