Dataset Information

Integrating Foundational Sciences in a Clinical Context in the Post-Clerkship Curriculum.

ABSTRACT: Purpose:To design, implement, and launch courses that integrate foundational science learning and clinical application in a post-clerkship undergraduate medical school curriculum. Method:In Academic Year (AY) 15-16, as part of a comprehensive curricular revision, Vanderbilt University School of Medicine (VUSM) formally implemented "Integrated Science Courses" (ISCs) that combined rigorous training in the foundational sciences with meaningful clinical experiences. These courses integrated foundational sciences that could be leveraged in the clinical environment, utilized a variety of instructional modalities, and included quantitative and qualitative (competency-based milestones) student assessments. Each ISC underwent a rigorous quality improvement process that required input on foundational science content, student experience, and student performance assessment. Results:Eleven ISCs were delivered to 173 students in AY15-16, with some students taking more than one ISC. Immediately after completing each course, 93% (n=222) of ISC enrollees completed a course evaluation. Students (91%; n=201) 'agreed' or 'strongly agreed' that foundational science learning informed and enriched the clinical experiences. Furthermore, 94% (n=209) of students thought that the clinical experiences informed and enriched the foundational science learning. Ninety-four percent of the students anticipated using the foundational science knowledge acquired in future clinical training and practice. Conclusion:The teaching of foundational sciences in the clinical workplace in the post-clerkship medical curriculum is challenging and resource-intensive, yet feasible. Additional experience with the model will inform the mix of courses as well as the breadth and depth of foundational science instruction that is necessary to foster scientifically-based clinical reasoning skills in each student.

SUBMITTER: Dahlman KB

PROVIDER: S-EPMC5889049 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Integrating Foundational Sciences in a Clinical Context in the Post-Clerkship Curriculum.

Dahlman Kimberly Brown KB Weinger Matthew B MB Lomis Kimberly D KD Nanney Lillian L Osheroff Neil N Moore Donald E DE Estrada Lourdes L Cutrer William B WB

Medical science educator 20180102 1

<h4>Purpose</h4>To design, implement, and launch courses that integrate foundational science learning and clinical application in a post-clerkship undergraduate medical school curriculum.<h4>Method</h4>In Academic Year (AY) 15-16, as part of a comprehensive curricular revision, Vanderbilt University School of Medicine (VUSM) formally implemented "Integrated Science Courses" (ISCs) that combined rigorous training in the foundational sciences with meaningful clinical experiences. These courses int ...[more]

PMID: 29632705

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Project description:BackgroundIncorporating ultrasound into the clinical curriculum of undergraduate medical education has been limited by a need for faculty support. Without integration into the clinical learning environment, ultrasound skills become a stand-alone skill and may decline by the time of matriculation into residency. A less time intensive ultrasound curriculum is needed to preserve skills acquired in preclinical years. We aimed to create a self-directed ultrasound curriculum to support and assess students' ability to acquire ultrasound images and to utilize ultrasound to inform clinical decision-making.MethodsThird year students completed the self-directed ultrasound curriculum during their required internal medicine clerkship. Students used Butterfly iQ+ portable ultrasound probes. The curriculum included online modules that focused on clinical application of ultrasound as well as image acquisition technique. Students were graded on image acquisition quality and setting, a patient write-up focused on clinical decision-making, and a multiple-choice quiz. Student feedback was gathered with an end-of-course survey. Faculty time was tracked.ResultsOne hundred and ten students participated. Students averaged 1.79 (scale 0-2; SD = 0.21) on image acquisition, 78% (SD = 15%) on the quiz, and all students passed the patient write-up. Most reported the curriculum improved their clinical reasoning (72%), learning of pathophysiology (69%), and patient care (55%). Faculty time to create the curriculum was approximately 45 h. Faculty time to grade student assignments was 38.5 h per year.ConclusionsStudents were able to demonstrate adequate image acquisition, use of ultrasound to aid in clinical decision-making, and interpretation of ultrasound pathology with no in-person faculty instruction. Additionally, students reported improved learning of pathophysiology, clinical reasoning, and rapport with patients. The self-directed curriculum required less faculty time than prior descriptions of ultrasound curricula in the clinical years and could be considered at institutions that have limited faculty support.

Project description:BackgroundIt is generally agreed that basic and clinical sciences should be integrated throughout the undergraduate medical education, however, there is still need for continued formal integration of basic sciences into clinical clerkship in many medical schools across the globe.MethodsUtilizing Kern's Six-Step Model of Instructional Design, we aimed to develop an intervention that would facilitate cognitive integration of basic and clinical sciences. After problem identification and targeted needs assessment through focused group discussion with the students and faculty, objectives were devised with an implementation plan of using flipped class approach to develop a content-focused and learner-centered teaching strategy. This intervention was piloted in the 2-week cardiology clerkship in Year 5. Evaluation of the content, integration, student and faculty experiences were recorded through in-depth interviews, FGDs and a formative MCQ test.ResultsFlipped classroom based integrated sessions were successfully developed. The implementation phase was met with challenges that primarily stemmed from the diverse teaching styles among faculty members, hesitance to deviate from conventional practices, variations in clinic timings, and demanding schedules. Noteworthy observations were in terms of ownership of the project, the need for faculty development in modern student-centered teaching pedagogies, opportunities for content improvement, scheduling of sessions, and suggestion of revisiting fundamental concepts in basic sciences through a brief boot camp-style session at the onset of the clerkship. The role of flipped case model and clinical cases in integrating basic sciences into clinical sciences were appreciated by the students. Standardization in teaching practices was identified as the major challenge by the faculty.ConclusionsA functional, learner-centered framework of cognitive integration of basic sciences in clinical sciences curriculum of cardiology rotation was developed with a potential to be implemented in other clerkship rotations.

Dataset Information

Integrating Foundational Sciences in a Clinical Context in the Post-Clerkship Curriculum.

Publications

Integrating Foundational Sciences in a Clinical Context in the Post-Clerkship Curriculum.

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