Abstract
Undergraduate medical education is moving from traditional disciplinary basic science courses into more integrated curricula. Integration models based on organ systems originated in the 1950s, but few longitudinal studies have evaluated their effectiveness. This article outlines the development and implementation of the Organic and Functional Systems (OFS) courses at the University of Minho in Portugal, using evidence collected over 10 years. It describes the organization of content, student academic performance and acceptability of the courses, the evaluation of preparedness for future courses and the retention of knowledge on basic sciences. Students consistently rated the OFS courses highly. Physician tutors in subsequent clinical attachments considered that students were appropriately prepared. Performance in the International Foundations of Medicine examination of a self-selected sample of students revealed similar performances in basic science items after the last OFS course and 4 years later, at the moment of graduation. In conclusion, the organizational and pedagogical approaches of the OFS courses achieve high acceptability by students and result in positive outcomes in terms of preparedness for subsequent training and long-term retention of basic science knowledge.
Highlights
Undergraduate medical curricula with discipline designs for the basic sciences are being replaced by curricula with units that integrate several disciplines [1,2,3,4,5]
The Organic and Functional Systems (OFS) courses' marks for successful students were stable across the years with average marks of 12.5, 13.1 and 13.6, out of 20, for OFS1, OFS2 and OFS3, respectively
With respect to the failure rates, there are two distinct periods: the initial 6 years, where the failure rate was of 0–9 %, and the last 4 cohorts in which it rose to 33 %
Summary
Undergraduate medical curricula with discipline designs for the basic sciences are being replaced by curricula with units that integrate several disciplines [1,2,3,4,5]. One way to integrate the basic sciences is to combine multiple disciplinary perspectives into courses that address organ systems, providing clinical contextualization [4,5,6,7,8,9]. We describe the Organic and Functional Systems (OFS) courses that integrate anatomy, biochemistry, embryology, histology and physiology. We use data collected longitudinally for 10 years to address the following questions: (i) how do students perform and how do students appreciate OFS?; (ii) how do OFS courses prepare students for subsequent courses and clerkships?; and (iii) is there long-term retention of basic science knowledge?
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