The Impact of a Pre‐Medicine Pharmacology‐Focussed Capstone in the Preparation of Students for Medical School

Abstract

Background and purpose Griffith University's accelerated two-year pre-medicine bachelor's degree that articulates into the four-year graduate Doctor of Medicine (MD) program, enrols 75 - 100 high-school students who rank > 99.5%. Their outstanding academic credentials notwithstanding, a quarter of this cohort has historically struggled to adapt to the PBL-focused MD curriculum with a deficiency of contextual learning, over reliance on superficial learning strategies, inexperience in problem-solving and lack of teamwork skills identified as contributing factors. This underpinned the rationale for the design and development of a capstone course Integrative Medical Sciences in 2016, to address these concerns and facilitate pre-medicine students’ transition to open-enquiry PBL in medical school. This study evaluated the impact of the capstone experience, including when it was delivered online due to Covid-19, in facilitating this transition. Methods Utilizing case-based learning (CBL), this capstone employs clinical cases focused on pharmacology as the ‘linking discipline’ to integrate and apply knowledge acquired through courses in anatomy, physiology, biochemistry and pathophysiology to understand the concepts of fundamental sciences that underpin disease. After four iterations of the capstone having been taught in small-group face-to-face settings, Covid-19 forced the abrupt transition to online delivery of live lectures, small-group CBL sessions, case-wrap sessions and assessments. Student evaluations of the course (SEC) were conducted at the end of the capstone, and longitudinal surveys of first- and second-year medical students assessed the impact of the capstone experience on their transition from pre-medicine to the MD program. Results SEC data for the past five years (50%-66% response rate) showed that the pharmacology-focussed capstone was extraordinarily effective; with a mean overall satisfaction score of 4.80/5.00 ± 0.09. The overall effectiveness of the transition to online delivery in 2020 was scored by students as outstanding (74.4%), good (19.2%) or satisfactory (6.4%) (n = 78; 100% response rate), with individual ratings being outstanding or good for online lectures (98.8%), CBL (93.6%), Case-wrap sessions (96.2%) and assessments (98.7%) (Figure 1). Most students (82%) encountered no problems with online learning, while 10% encountered some technical difficulties. Students perceptions of the effectiveness of the capstone delivered online or face-to-face (in 2018 and 2019) revealed both approaches to be equally effective (Figure 2). Additionally, first-year medical students rated the overall impact of the pre-medicine capstone on their transition to PBL in the MD program as significantly positive (96%) or somewhat positive (4%) (n = 51; 64% response rate); whereas second-year medical students rated this as significantly positive (96%), somewhat positive (2%) or negligible (2%)(n = 43; 63% response rate). Conclusions A pharmacology-focussed capstone course delivered utilizing small-group CBL in the pre-medicine degree was perceived by students to be very helpful in transitioning to open-enquiry PBL in graduate medical school. The online delivery of the capstone necessitated by Covid-19, was found to be as effective as when it was delivered face-to-face.