Integrating Foundational Sciences in a Clinical Context in the Post-clerkship Curriculum
This study aims to design, implement, and launch courses that integrate foundational science learning and clinical application in a post-clerkship undergraduate medical school curriculum.
In academic year 2015–2016 (AY15–16), 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.
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.
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.
KeywordsCurriculum 2.0 Integrated science courses Foundational science
We thank Dr. Bonnie Miller and the Vanderbilt University School of Medicine (VUSM) leadership for their support, the ISC directors, and the faculty who delivered and/or reviewed the foundational sciences in the ISCs. We also thank Dr. Charlene Dewey for constructing and executing Curriculum Design Sessions for the ISC directors. The Immersion Phase medical student liaisons Deirdre Finnegan, Nathan Friedman, and Jared Shenson provided ongoing course feedback. Special thanks to Brenna Hansen and Kacy Morgan, Immersion Phase Program Coordinators, for their administrative support.
Kimberly Brown Dahlman was supported in part by grants 5P30CA068485-21 and U10CA180847 from the National Institutes of Health (NIH) and the TJ Martell Foundation. Neil Osheroff was supported in part by grant GM033944 from the NIH and Merit Review award I01Bx002198 from the United States Veterans Administration. Matthew Weinger’s time was supported in part by the Geriatric Research Education and Clinical Centers of the Department of Veterans Affairs. Donald E Moore was supported in part by CMS Contract 1L1CMS331461-01-00 with Vanderbilt University and The Mid-South Practice Transformation Network. The innovation described in this study was implemented with partial financial support from the American Medical Association (AMA) as part of its Accelerating Change in Medical Education Initiative. The content of this manuscript reflects the views of VUSM and does not necessarily represent the views of AMA or other participants in this Initiative.
Compliance with Ethical Standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Conflict of Interest
The authors declare that they have no conflict of interest.
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