Contextualizing the relevance of basic sciences: small-group simulation with debrief for first- and second-year medical students in an integrated curriculum

Abstract

AimThere has been a call for increased integration of basic and clinical sciences during preclinical years of undergraduate medical education. Despite the recognition that clinical simulation is an effective pedagogical tool, little has been reported on its use to demonstrate the relevance of basic science principles to the practice of clinical medicine. We hypothesized that simulation with an integrated science and clinical debrief used with early learners would illustrate the importance of basic science principles in clinical diagnosis and management of patients.MethodsSmall groups of first- and second-year medical students were engaged in a high-fidelity simulation followed by a comprehensive debrief facilitated by a basic scientist and clinician. Surveys including anchored and open-ended questions were distributed at the conclusion of each experience.ResultsThe majority of the students agreed that simulation followed by an integrated debrief illustrated the clinical relevance of basic sciences (mean ± standard deviation: 93.8% ± 2.9% of first-year medical students; 96.7% ± 3.5% of second-year medical students) and its importance in patient care (92.8% of first-year medical students; 90.4% of second-year medical students). In a thematic analysis of open-ended responses, students felt that these experiences provided opportunities for direct application of scientific knowledge to diagnosis and treatment, improving student knowledge, simulating real-world experience, and developing clinical reasoning, all of which specifically helped them understand the clinical relevance of basic sciences.ConclusionSmall-group simulation followed by a debrief that integrates basic and clinical sciences is an effective means of demonstrating the relationship between scientific fundamentals and patient care for early learners. As more medical schools embrace integrated curricula and seek opportunities for integration, our model is a novel approach that can be utilized.

Integration of Basic and Clinical Sciences: Faculty Perspectives at a U.S. Dental School

“…Most scholarship regarding integration is found in the medical education literature. With regard to integrating clinical relevance in basic science courses, both simulation 16 , 17 and live patient 18 interactions have been found to have potential. Integration of basic sciences into clinical years might involve formally revisiting basic science courses; 6 examples involve anatomical reviews or hands‐on activities 19 – 22 .…”

Utilization of high-fidelity simulation to address challenges with the basic science immunology education of preclinical medical students

“…The students were equipped to partake in simulation because of our highly integrated curriculum. Students participated in a physical examination course, communications/history taking course and clinical reasoning course during their first year of medical school [25, 26]. All medical students were Emergency Medical Technician (EMT) certified during the first year of medical school and longitudinally participated in EMT shifts during year one [27].…”

The Simulated Virology Clinic: A Standardized Patient Exercise for Preclinical Medical Students Supporting Basic and Clinical Science Integration

“…7 Most medical schools employing simulation in the preclinical years have used it to teach clinical skills, with few publications thus far describing its use for basic science instruction. [8][9][10] Examples of simulation-based instruction include standardized patient (SP) encounters, in which learners interact with patient actors in order to practice or be assessed on performance of one or more patient-encounter tasks. 11 SP encounters are one example of whole-task instruction, in which learners' tasks represent the complexity of real-life clinical tasks rather than only one part or subset.…”