Integration Of Basic Sciences Research Articles

Integrating basic sciences into clerkship rotation utilizing Kern’s six-step model of instructional design: lessons learned

BackgroundIt is generally agreed that basic and clinical sciences should be integrated throughout the undergraduate medical education, however, there is still need for continued formal integration of basic sciences into clinical clerkship in many medical schools across the globe.MethodsUtilizing Kern’s Six-Step Model of Instructional Design, we aimed to develop an intervention that would facilitate cognitive integration of basic and clinical sciences. After problem identification and targeted needs assessment through focused group discussion with the students and faculty, objectives were devised with an implementation plan of using flipped class approach to develop a content-focused and learner-centered teaching strategy. This intervention was piloted in the 2-week cardiology clerkship in Year 5. Evaluation of the content, integration, student and faculty experiences were recorded through in-depth interviews, FGDs and a formative MCQ test.ResultsFlipped classroom based integrated sessions were successfully developed. The implementation phase was met with challenges that primarily stemmed from the diverse teaching styles among faculty members, hesitance to deviate from conventional practices, variations in clinic timings, and demanding schedules. Noteworthy observations were in terms of ownership of the project, the need for faculty development in modern student-centered teaching pedagogies, opportunities for content improvement, scheduling of sessions, and suggestion of revisiting fundamental concepts in basic sciences through a brief boot camp-style session at the onset of the clerkship. The role of flipped case model and clinical cases in integrating basic sciences into clinical sciences were appreciated by the students. Standardization in teaching practices was identified as the major challenge by the faculty.ConclusionsA functional, learner-centered framework of cognitive integration of basic sciences in clinical sciences curriculum of cardiology rotation was developed with a potential to be implemented in other clerkship rotations.

Rethinking Basic Science Integration in Clinical Electives.

Rethinking Basic Science Integration in Clinical Electives.

Transition towards the integration of basic sciences in medical education

Transition towards the integration of basic sciences in medical education

Advances and Future Prospects of Wearable Textile‐ and Fiber‐Based Solar Cells

Carbon neutrality is one of the most urgent global missions and has promoted the development of clean and renewable energy sources. Sustainable photovoltaic cells have become ideal candidates for green energy harvesting owing to their high power conversion efficiencies and low production costs, which can efficiently reduce the carbon emissions. In recent years, with the increasing advancements in wearable electronics, flexible photovoltaic textile devices have been regarded as the most promising energy resources for Internet of Things. Accordingly, herein, an up‐to‐date account of the recent advancements in modern textile‐based solar cells (i.e., organic, perovskite, and dye‐sensitized solar cells) based on both fibers and fabrics for highly effective harvesting of solar energy is provided, and their fundamental designs and optimization strategies are comprehensively reviewed. This review emphasizes the unique characteristics, underlying mechanisms and potential applications of textile‐based solar cells. Moreover, a modern perspective on both challenges and opportunities in the advancements of the interesting textile‐based solar cells embedded in wearable devices is elucidated. This review offers new insights into advanced energy technologies and smart wearable devices that would facilitate multidisciplinary integration of basic science, device engineering, industrial applications, and other scientific domains.

Use of a consortium to provide continuity in physician training: The OU-COM experience.

This article describes initiatives undertaken by the Ohio University College of Osteopathic Medicine (OU-COM) to develop a continuum of physician training that emphasizes the integration of basic sciences throughout undergraduate and graduate medical education. These initiatives demonstrate the effectiveness of consortia in actually restructuring educational programs, decreasing fragmentation, and promoting continuity.

Development and Implementation of a Medical School Course Integrating Basic, Clinical, and Health Systems Sciences.

In recent years, significant steps have been made in integrating basic science and clinical medicine. There remains a gap in adding the third pillar of education: health systems science (HSS). Core clerkships represent an ideal learning venue to integrate all three. Students can experience the value of integrating basic science as they learn clinical medicine in environments where HSS is occurring all around them. We outline the creation of Sciences and Art of Medicine Integrated (SAMI), a course that runs parallel with the clerkship year and integrates basic science and HSS with clinical medicine. A complete description of the planning and implementation of SAMI is provided. We include the participants and educational setting, the goals and objectives, and the structure of each session. To encourage the integration of basic science, HSS, and clinical medicine, students utilize a series of tools, described in detail. Examples of each tool are provided utilizing a case of a patient presenting with obstructive sleep apnea. We successfully implemented this course with positive reception from students. This course represents a step not only toward the integration of HSS with basic science and clinical medicine but also an advancement in training future clinicians to provide high-value care. Future curricular development must consider the validation of a measure of clinical reasoning that assesses a student's ability to think in a cognitively integrated fashion about basic science, HSS, and clinical medicine demonstrated by enhanced justification of clinical reasoning and a more holistic approach to planning patient care.

Vertical Integration of Teaching–Learning Methods for Clinical Tests of Hearing with the Physiology of Hearing: A Proposed Curriculum Improvisation Model for Undergraduate Medical Students

Introduction: Early clinical exposure (ECE) is a tried and tested attempt in teaching-learning methods (TLMs) to achieve the goal of integrating basic sciences with clinical methods and helps in creating competent clinicians for health-care delivery system. Vertical integration of basic sciences with clinical subjects, which improves problem-based learning, has met with considerable success. However, there is no ECE module for otology in the 1st-year physiology curriculum at present. Clinical skills training in otology is conventionally imparted only during the initial phase of final MBBS. Hence, there is a large time gap between learning the physiology of hearing and the actual implementation of that knowledge during learning clinical of assessment of hearing. The present study tested vertical integration of knowledge of physiology of hearing with clinical knowledge of assessment of hearing with the intention to achieve certain expected outcomes like better clinical skills in students, faculty development, overall improvement in the quality of management of patients with hearing loss, and the long-term and far-reaching positive impact on the community as a whole. Materials and Methods: 150 undergraduate 3rd year students of a medical college participated in the study. They were divided into two groups of 75 each. Pilot tested validated pretest questionnaires were offered to both the groups before intervening with the TLM. Group “A” was exposed to the vertical integration module, while Group “B” served as a control. Thereafter, Group “A” and “B” were further subdivided into five smaller groups each and a 60-min tutorial on tests of hearing was conducted for each of the small groups. Pilot tested validated posttest questionnaires were then offered to both the groups. Finally, feedback on the intervention was obtained through a pilot tested validated feedback form based on a five-point Likert scale from all participants. Results: The results showed that vertical integration promotes interaction among faculty from different departments and improves decision making abilities when designing and implementing appropriate TLM. It also improves learning outcomes among students by identifying the exact need for curriculum development and designing and testing an appropriate module for a particular task at hand. Conclusion: Competency-based medical education is the need of the hour and ECE is the most important step toward this. Appropriate vertical integration of various topics across all subjects is a long drawn out and time consuming task. However, by consistent inter-departmental faculty interaction and enthusiastic approach toward curriculum designing and development, the overall goal of training a medical graduate for transiting into an asset to the society seems achievable.

Recall of Prior Knowledge in Medical Microbiology Among Medical Interns: A Multicenter Cross-Sectional Assessment in Saudi Arabia.

BackgroundRetention of basic biomedical sciences knowledge is of great importance in medical practice. This study aimed to provide some insights into medical interns’ ability to recall theoretical knowledge of medical microbiology and to explore factors that affect its retention.MethodsIn this cross-sectional study conducted between January and March 2019, an anonymized questionnaire with 10 validated multiple-choice questions about medical microbiology was distributed as hard copies to test the ability to recall knowledge of Saudi medical interns in three tertiary training hospitals in Riyadh, Saudi Arabia.ResultsA total of 300 medical interns [164 females (54.7%) and 136 males (45.3%)], in three major tertiary medical care centers in Riyadh, Saudi Arabia, voluntarily participated in the study. Almost a third of participants, 107 (36.4%), graduated from medical schools adopting a traditional curriculum, whereas 184 (63.6%) graduated from medical schools adopting problem-based learning (PBL) instructional approach. The overall mean score out of 10 marks was 3.9±1.8 with almost 82% failures scoring less than six marks. Both total and pass/fail grades were significantly associated with interns who graduated from private colleges. Scores were not significantly associated with any of the investigated parameters except type of college (governmental vs private) with a p-value of 0.049.ConclusionThe current study revealed an overall poor recall of knowledge in microbiology among interns. Our findings suggest a need for a careful revision of curriculum to correct deficiencies, particularly in teaching medical microbiology. Integration of basic sciences is required as well as aligning teaching of basic medical sciences with clinical skills.

Cadaveric Clinical Integration: Integration of Basic Science and Medical Science

IntroductionCadaveric dissection is an integral part of many medical schools and provides an opportunity for students to visualize anatomical structures through active learning and critical thinking. Often during dissection, several pathological features and medical interventions can be identified, but are not regularly explored due to time or knowledge constraints. To encourage horizontal integration of content, a self‐directed learning (SDL) activity was implemented across four concurrent courses, gross anatomy (MGA), Foundations of Medicine which includes histology and physiology (FOM), Practice of Medicine that includes physical examination (POM) and Engineering Innovation (ENG). The goal of this longitudinal experience was to foster integration of basic science with clinical science thereby increasing metacognitive and lifelong learning skills.Methods49 students enrolled in the Engineering‐Medicine dual degree program at Texas A&M College of Medicine were divided into 7 groups, based on the cadaveric dissection assignments in MGA. Over the 16‐week MGA course, students documented the medical interventions and pathology found during dissection. During most dissection labs, a surgeon related to the field was present to answer questions. In addition, at three time points in the semester an anatomical pathologist performed a modified autopsy on the cadavers based on students request. This self‐directed, problem‐based learning (PBL) activity culminated in a forensic clinical summary, reconstructed comprehensive patient encounter 1 year prior to death, and 15‐minute oral presentation of their findings of their assigned cadaver. To assess potential changes in learning behavior, students completed a 46‐question, 8 subcategory modified Motivated Strategies for Learning Questionnaire (MSLQ) related to the activity. In addition, student’s provided verbal and written feedback on their perceptions of the project.Results47 out of 49 students successfully completed all aspects of the project. The was a positive trend and strong correlation in 7 out of 8 MSLQ categories, including intrinsic motivation, metacognition, task value, critical thinking, self‐efficacy, peer learning and help seeking. A paired t‐test showed a decrease in student's extrinsic motivation (t(46) = 1.831, p = 0.037) as related to the project. Students reported an overall high satisfaction with the project. The student presentations demonstrated high level of integration of basic science with clinical medicine.Conclusion/ImplicationThis innovative multi‐disciplinary activity increased the value of cadaveric dissection, integration of content across courses, and promoted self‐directed learning of integrated clinicopathology material.

Student Perspectives of Threshold Concepts in Undergraduate Medical Education for Understanding the Structure and Function of the Human Body

The purpose of a curriculum is to produce individuals with proficiency in content knowledge, ability to apply knowledge, and eventually become experts in a given field. One theory of how students transition into thinking like an expert is through the acquisition of threshold concepts. Threshold concepts are pieces of knowledge in a field that, once understood, produce a qualitative shift in a student’s thinking and increases their potential to become an expert in that field. There is sparse research in threshold concepts in medical education, and most of the current literature either focuses on aspects of clinical practice or serves as a discussion piece with no empirical evidence. There are even fewer studies that attempt to identify the threshold concepts for understanding the scientific principles that underlie medicine as a field, and these studies often rely only on expert opinions. This is a shortcoming since experts in undergraduate medical education, often Ph.D. researchers, have a very different perspective than the medical student currently grappling with the scientific concepts for the first time. This study aims to address this gap in the literature by conducting focus groups with medical students in all four years of undergraduate medical education (M1‐M4) at a large allopathic medical school to examine which concepts students identify as threshold concepts in medical education for understanding the human biology. All curricular years were included determine the student perspectives at each stage of undergraduate medical education and capture any potential shifts throughout the medical curriculum in the clinical and pre‐clinical years. Sessions were semi‐structured and asked questions that inquired about the threshold concepts for understanding the human biology for medical practice. Focus group sessions were recorded, transcribed and analyzed using thematic analysis. Three M4 students, ten M3 students, nine M2 students and four M1 students participated in focus groups. At the present time, data are still undergoing thematic analysis. Thus far, the major codes emerging pertain to cardiovascular, pulmonary, renal physiology and neurobiology as potential threshold concepts. Students also identified as pathology as a potential threshold concept since it integrates the knowledge they have previously learned and applies it to medical practice. A theme that appears to be emerging is the importance of hands‐on patient/clinical experience to push students through the threshold into understanding a particular scientific concept. As the analysis of the data is completed, the results of this study will offer insight for medical educators on how to adapt their curricula to better suit the needs of their students. This may include further integration of basic science and clinical education, providing students opportunities to work with patients earlier in their education and/or shifting the emphasis to the most clinically relevant systems.

A randomized trial comparing cadaveric dissection and examination of prosections as applied surgical anatomy teaching pedagogies.

Anatomy is an important component in the vertical integration of basic science and clinical practice. Two common pedagogies are cadaveric dissection and examination of prosected specimens. Comparative studies mostly evaluate their immediate effectiveness. A randomized controlled trial design was employed to compare both the immediate and long-term effectiveness of dissection and prosection. Eighty third-year medical students undergoing their surgical rotation from the Yong Loo Lin School of Medicine were randomized into two groups: dissection and prosection. Each participated in a one-day hands-on course following a similar outline that demonstrated surgical anatomy in the context of its clinical relevance. A pre-course test was conducted to establish baseline knowledge. A post-course test was conducted immediately after and at a one-year interval to evaluate learner outcome and knowledge retention. A post-course survey was conducted to assess participant perception. Thirty-nine and thirty-eight participants for the dissection and prosection groups, respectively, were included for analysis. There was no significant difference between mean pre-course test scores between the dissection and prosection groups [12.6 (3.47) vs. 12.7 (3.16), P>0.05]. Both the mean immediate [27.9 (4.30) vs. 24.9 (4.25), P<0.05] and 1year [23.9 (4.15) vs. 19.9 (4.05), P<0.05] post-course test scores were significantly higher in the dissection group. However, when adjusted for course duration [dissection group took longer than prosection group (mean 411 vs. 265min)], these findings were negated. There is no conclusive evidence of either pedagogy being superior in teaching surgical anatomy. Based on learner surveys, dissection provides a greater learner experience.

Improving Integration of Basic Science into Clinical Medicine: Vertical Integration into Clinical Education (VICE) Activity.

The online version contains supplementary material available at 10.1007/s40670-021-01485-7.

Laboratory reports as a learning tool – Early clinical exposure in 1st-year MBBS physiology (Hematology)

Background: Early clinical exposure (ECE) aims to bridge the gap between pre-clinical and clinical subjects. ECE exposes students to the health-care system at an early stage of professional life, follows patient-centered approach, and increases motivation for classroom learning. Most of the studies have reported a positive attitude of students toward ECE. However, very few studies have reported the difficulties that may be faced by the students during implementation of ECE. Aim and Objectives: The aim of this was to explore the attitude of students and difficulties faced if any during implementation of ECE in 1st MBBS Physiology (Hematology) with the help of laboratory reports and clinical scenarios. Materials and Methods: One hundred and ten students participated after completion of theory and practical classes of hematology. Clinical scenarios and laboratory forms were prepared based on actual laboratory reports of patients from pathology department. Group discussions and discussion with faculty was done. Attitude of the students was noted. Results: Most of the students found this method to be interesting and better than routine methods, helped in better understanding of theory and practical concepts, and helped in better preparation for examinations and better clinical correlations. However, about half of the students agreed or were not sure about the difficulty of ECE. Conclusion: The positive attitude of the students shows that ECE provides a successful integration of basic science and clinical subjects. It also helps in understanding the relevance of a basic science subject. Concepts of the subjects are made easier and interesting by ECE. However, the difficulties faced by the students should be kept in mind and more practice sessions may be done.

No Need to Reinvent ‐ Augmenting a Flipped Class Histology Curriculum with a Commercial Online Course

Histology, a pillar of anatomical sciences for both health professional and graduate students, requires sufficient time and practice to develop the necessary visual literacy and skills in synthesis to achieve competency. However, histology contact hours in medical and graduate education have reduced significantly in the past decades due to disseminated curricular changes emphasizing integration of basic sciences, clinical content and self-directed learning. In turn, adjunct online resources have been in steady incline and in the past year, in response to COVID-19, quickly became an essential component of anatomical sciences education following campus closures. Self-directed learning is challenging in normal circumstances as success is impacted by the level of student preparedness and engagement, which in turn can be dependent on the quality of the asynchronous learning resources. Although many online histology resources are available, few are comprehensive and provide step-by-step instruction in identification of structures in tissue slides. In this pilot project, the efficacy of using a commercial online histology (COH) course (DaVinci Academy, Cleveland, OH) as a primary preparatory resource in a graduate histology curriculum implementing a flipped-classroom pedagogy was assessed. During fall 2020 (F2020), first-year graduate students enrolled in a hybrid histology course were required to review learning objectives, read textbook sections, and complete the COH lessons, consisting of complete lectures, lab videos, and quizzes as a set of pre-work to prepare for on-campus and virtual classes. The synchronous class sessions had minimal didactic lectures, but instead had a series of small group active learning tasks. In a COMIRB exempt retrospective study (#20-2891), the assessment outcomes of the F2020 cohort (n=26) were compared to a fall 2019 (F2019) cohort of students (n=25) who completed the identical histology curriculum delivered in a flipped-class style by the same instructor, but without the commercial online histology course. All course quiz and exam scores were compared across the F2019 and F2020 cohorts using a Kruskal Wallis test for non-parametric data. There were no significant differences in assessment outcomes between F2019 and F2020 cohorts (p>0.05). Survey of the F2020 cohort throughout the course revealed consistently high rating of the COH with 80% of students believing the resource improved their ability to read and interpret histology slides. Interestingly, students perceived the lecture and lab videos in the COH delivered by the same in-class instructor to be more valuable than those delivered by a third-party instructor, although the assessment performance was independent of the online instructor (p>0.05). The results suggest that the online histology course can be an effective asynchronous learning resource for a histology course, allowing for more efficient use of synchronous class time to support a higher taxonomy of learning.

Educational innovation in the comprehensive training of nursing graduates

A multi and interdisciplinary teamwork was developed on the integration of basic sciences among themselves and their contribution to professional training. Work was done on the identification of essentialities, organization and structuring of contents according to the requirements and precedence relationships of the Nursing discipline. The general objective was to identify the interdisciplinary relationships between the basic sciences of the nursing career to improve the quality of teaching. A qualitative and descriptive study was carried out through a historical-logical analysis based on documents, syllables, teachers of the basic training semesters and students. Interviews with teachers and student surveys were applied and it was found that there is a need to develop methodological career work aimed at disciplinary integration. Failures were detected such as an inadequate perception of the students about the role of interdisciplinarity in their training, no planning of methodological career activities that promote interdisciplinarity, dissatisfaction with integration in knowledge-integrating projects, and the need for methodological proposals for the interdisciplinarity from the first year of the degree. An integration of the contents was achieved with an inter and transdisciplinary approach, which is recognized as having a favorable impact on academic success and the quality of teacher training.

Technology-enhanced learning: a role for video animation

The last 20 years has seen a shift in medical education from printed analogue formats of knowledge transfer to digital knowledge transfer via media platforms and virtual learning environments. Traditional university medical teaching was characterised by lectures and printed textbooks, which to a degree still have an important role to play in knowledge acquisition, but which in isolation do not engage the modern learner, who has become reliant on digital platforms and 'soundbite' learning. Recently, however, traditional methods of teaching and learning have been augmented by, and indeed sometimes replaced by, the alternative learning methods such as: problem-based learning; a greater integration of basic science and clinical considerations; smaller teaching groups; the 'flipped classroom' concept; and various technological tools which promote an interactive learning style. The aim of these new teaching methods is to overcome the well-documented limitations of traditional lectures and printed material in the transfer of knowledge from expert to student, by better engaging the minds of more visual learners and encouraging the use of diverse resources for lifelong learning. In this commentary paper, we share the concept of video animation as an additional educational tool, and one that can help to integrate molecular, cellular and clinical processes that underpin our understanding of biology and pathology in modern education. Importantly, while they can provide focused and attractive formats for 'soundbite' learning, their aim as a tool within the broader educational toolbox is to direct the interested reader towards more traditional formats of learning, which permit a deeper dive into a particular field or concept. In this manner, carefully constructed video animations can serve to provide a broad overview of a particular field or concept and to facilitate deeper learning when desired by the student.

Louisiana State University School of Medicine in New Orleans.

Louisiana State University School of Medicine in New Orleans.

University of South Alabama College of Medicine.

University of South Alabama College of Medicine.

Texas A&M University College of Medicine.

Texas A&M University College of Medicine.

&lt;p&gt;Social Constructivism in Medical School Where Students Become Patients with Dietary Restrictions&lt;/p&gt;

BackgroundExperiential vertical integration of basic science with clinical concepts remains a challenge in medical school curricula. In addition, training physicians in nutritional competency that translates into patient care is a challenging endeavor ranging from biochemical mechanisms to socioeconomic challenges.MethodsEmploying a social constructivism paradigm, we implemented a collaborative cook-off competition in a basic science course where 140 first-year medical students per year translated their studies of inborn errors of metabolism, energy metabolism, micronutrients and immunology into edible creations intended for people with disorders requiring dietary management. After learning about the disorders in lecture, problem-based learning, team-based learning and through patient interviews, four problem-based learning groups (7 students per group) were assigned to prepare food dishes for one of the five assigned disorders. Together, students researched the dietary requirements, shopped, paid for, prepared, presented and shared their food. To the class, faculty and re-invited patients, the groups explained the dietary restrictions, the chosen ingredients, how they prepared the food, and why their dish was suitable for the disorder. Each category was judged and awarded a first-place food prize with a grand prize at the end. At the completion of the course, student feedback was elicited via anonymous evaluations. Over 3 years, 380 comments were collected. We used grounded theory to generate a codebook that was then analyzed by the authors for overarching themes.ResultsQualitative results described three major themes: increased relevance of basic science to real life, increased empathy towards complying with dietary restrictions, and increased student group cohesiveness.ConclusionThe patient-centered cook-off competition taught students the relevance of basic science but in addition, it taught empathy towards the patient experience. We also discovered that the process of food preparation was a bonding experience that promoted collaboration, cohesiveness and friendship within the student class.