TF7 A Novel Integrated Learning Approach for Pre-Clinical Medical Students Through Early Procedural Exposure and Simulation

Abstract

Much of existing pre-clinical basic science curriculum consists of lecture, reading, and standardized tests. Outside of the anatomy lab, many first- and second-year medical students (MS-1s, MS-2s) lack hands-on experiential learning. For visual and kinesthetic learners who thrive in a student-centered learning environment, new curricula must be offered to accommodate adult learners. The goal of this project is to offer MS-1s and MS-2s a novel integrated learning approach to medical curricula in their pre-clinical years through early procedural and simulation exposure. Four separate workshops occur over the course of a year to encourage diagnostic reasoning and procedural intervention. Through practical application of theoretical knowledge, students will dynamically engage with real-world medical cases and diagnostic dilemmas. During this series of workshops, the learner will be expected to (1) recall existing pre-clinical knowledge, (2) build knowledge though videos, online, and in-person curricula, (3) synthesize basic science knowledge with real-world application, (4) propose differential diagnoses and formulate treatment plans, and (5) perform hands-on procedures and practice clinical skills. In relation to entrustable professional activities (EPAs) medical students will: 1- Gather a history and perform a physical exam, 2- Prioritize a differential diagnosis, 3- Recommend and interpret common diagnostic and screening tests, 4- Form clinical questions and retrieve evidence to advance patient care, 5- Recognize a patient requiring urgent or emergent care and initiate evaluation and management, 6- Obtain informed consent for tests and/or procedures, and 7- Perform general procedures. The instruction will occur in a series of four workshops offered over 12 months (4 quarterly four-hour sessions), which is independent of, but complementary to, the pre-clinical curriculum. Each workshop has a pre-test and content overview including videos and interactive online materials. The in-person workshop consists of integrating diagnostic reasoning and procedural skills through case simulations. Students will rely on their classroom-based knowledge and underlying understanding of systems-based disease processes to work through the patient cases. Through scenarios such as headache with altered mental status (lumbar puncture), sepsis (central line), trauma (laceration repair/splinting), and vision loss (slit lamp exam, tonometry) students will perform procedures firsthand. The curriculum will guide the learners through independent study, group collaboration, critical reasoning, hands-on skills practice, and reflection. Students complete a post-test immediately following the workshop and at 3 months to gauge retention of the material covered. The curriculum was successfully piloted for MS-1s and MS-2s. 100% felt the curriculum was successful. Using a Likert scale of 1 (poor) to 5 (excellent), the average score was 4.8. In the future, the curriculum will be expanded in breadth of content and variety of teaching modalities. Further curriculum evaluation is needed to justify adding the proposed workshop-based curriculum to pre-clinical medical education and continued in perpetuity.