Integrating the Basic and Clinical Sciences in the Minds of Learners: Where the Rubber Meets the Road in Transforming Medical Education

From the 12/18/2020 newsletter

 

 

Workshop Review

 

 

Integrating the Basic and Clinical Sciences in the Minds of Learners: Where the Rubber Meets the Road in Transforming Medical Education

 

 

Jacob Prunuske, MD, MSPH and Amy J. Prunuske, PhD - Faculty members at MCW-Central Wisconsin

 

 

Drs. Prunuske describe a recent workshop that illustrates the key concepts to transforming medical education …

 

 

On November 24, 2020, MCW hosted an event co-sponsored by the Office of Academic Affairs and the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education that reflected MCW’s commitment to transforming how we approach medical education. The afternoon event consisted of a plenary and two workshops. 

 

 

Plenary Session: Promoting Cognitive Integration and Student-Centered Learning

 

The plenary was delivered by Amy Wilson-Delfosse, PhD, the Associate Dean for Curriculum at Case Western Reserve University School of Medicine, and Leslie Fall, MD, the Chief Executive Officer of Aquifer, a non-profit dedicated to delivering high-impact, virtual health care education.  The session focused on the key principle that cognitive integration must occur in the learner’s mind and thought processes. Medical educators must, therefore, design educational experiences that foster cognitive integration because that is the essence of what it means to be a doctor. Facts, figures, pictures, and diagrams are all available with quick internet searches, yet the availability of this material does not make someone a doctor. Rather, clinicians must be able to integrate the basic and clinical sciences within the context of patient needs, family dynamics, and community resources, and then develop appropriate differential diagnosis and management plans. Educators must support this cognitive integration and not limit their teaching to a simple transfer of facts and figures. 

 

Basic scientists and clinicians sometime lack a common language to describe key concepts. This disconnect increases the cognitive load for medical students and decreases the likelihood that students will learn to truly integrate basic and clinical concepts. To help alleviate this load, educators should identify the top clinically relevant concepts every medical student must be able to understand and apply in clinical situations to make safe, effective, and high-quality decisions. To meet this goal, medical educators must craft learning objectives that challenge students to justify clinical decisions using core basic science concepts.

 

 

Webshop: Student Centered Teaching and Learning (Dr. Wilson-Delfosse)

 

Following the plenary, Dr. Wilson-Delfosse presented the first webshop. Participants identified the MCW “Ideal Learner” as curious, reflective, humble, self-aware, adaptive, and collaborative. These characteristics align well with the educational philosophy of the Master Adaptive Learner framework. With the support of a robust coaching and support system, medical students must engage in four critical phases to develop the skills of a master adaptive learner: 

 

·      Planning phase: students identify gaps, select opportunities for learning, and search for learning resources. 

·      Learning phase: students critically appraise the resources they use for learning and intentionally practice effective study and learning strategies. 

·      Assessment phase: students assess themselves and receive feedback from others. 

·      Adjusting phase: students demonstrate an ability to transfer learning to both routine and novel clinical situations. 

 

Dr. Wilson-Delfosse highlighted a practical application: the Master Adaptive Learner Checklist. This checklist provides a template for medical educators to assess whether any given educational session fosters master adaptive learning skills development. MCW participants in the webshop were given the opportunity to apply this checklist to instructional vignettes, highlighting the value of the checklist for improving and aligning educational sessions.

 

Finally, Dr. Wison-Delfosse emphasized our role as medical educators in attending to student learning experiences and serving to energize and invigorate student excitement about learning. 

 

 

Webshop: Integration of Basic Sciences into Clinical Reasoning and Decision Making (Dr. Fall) 

 

Dr. Fall presented the second webshop. She described how the use of integrated illness scripts and mechanism of disease mapping supports student learning by integrating basic, clinical, and health systems sciences. This results in improved retention of information. Mapping of mechanisms of disease creates visual representations that foster integration of key scientific concepts and provide frameworks for exploring the art and practice of clinical medicine. 

 

MCW participants then applied these concepts to case-based learning strategies. By comparing and contrasting causal mechanisms of disease and illness scripts, participants provided rationales for laboratory evaluation, imaging, and clinical next steps. 

 

 

We look forward to applying the ideas and concepts presented during this event to our efforts to redesign our MCW curriculum. We encourage you to watch and review these sessions and explore opportunities to promote Cognitive Integration and Student-Centered Learning in your courses and clerkships. 

 

Recordings of the sessions are available here:

 

·      Plenary Session
Webshop 1- Student Centered Teaching and Learning

·      Webshop 2- Integrating Basic Sciences into Clinical Reasoning & Decision Making

 

 

 

 

Jacob Prunuske, MD MSPH is the Assistant Dean for Clinical Learning at MCW- Central Wisconsin.

 

Amy Prunuske, PhD is on the basic science faculty at MCW-Central Wisconsin.