Moderated by Bonnie Granat

PRESENTATION 1 - Applying Cognitive Integration: a Novel Asynchronous Foundational Science Curriculum for Medical Students During Clerkships    
Katherine Hyland    
University of California, San Francisco

PURPOSE Cognitive integration (CI) connects foundational science (FS) to medical practice and improves clinical reasoning. While evidence supports CI in medical training, the clinical relevance of FS is often obscure to medical students, and few learning materials exist to support CI during clerkships. Providing effective and engaging tools to promote CI may enhance understanding of the clinical relevance of FS. We therefore aimed to create an online module to integrate FS into clerkships.

METHODS Previous student feedback at our institution advocated for clinically relevant FS content. Applying Cognitive Theory of Multimedia Learning principles, we (an oncologist, a biochemist, and an instructional designer) created a cancer module grounded in the hallmarks of cancer (HoC), a key FS principle. To emphasize clinical relevance, we recorded patient interviews incorporating FS. The module, composed in Qualtrics, includes an introduction and four vignettes, each starting with a brief patient interview, followed by clinical text, images, questions, and explanations. Content co-created by the oncologist and biochemist combined clinical and FS perspectives while referencing HoC throughout. The evaluation plan includes written learner feedback, a case-based pre/post-test, and review of clerkship assessments for evidence of CI.

RESULTS Module completion takes two hours, which can be divided into multiple sittings. Filming and editing cost $100/hour. The project required approximately 60 faculty person-hours and 12 instructional designer person-hours. Interviewed patients expressed gratitude for sharing their stories with students.

CONCLUSION This novel interactive module can serve as a model for development of clerkship curricula promoting CI. Module creation based on real patients resulted in authentic story-telling and enhanced FS relevance. Content development involving a clinician and a basic scientist aligned with CI goals. Limitations include the need for funding and instructional design assistance. For future iterations, involving learners in curriculum development may decrease faculty burden and increase student interest in FS.

PRESENTATION 2 - Pipelining Health Systems Science in Postbaccalaureate Premedical Programs    
Stephen Schneid    
University of California, San Diego

Purpose Health System Science (HSS) is recognized as the third pillar of medical education that teaches how systems of health are designed, delivered, and impact populations. Undergraduate medical education (UME) has incorporated HSS into their curricula, yet reported mixed student receptivity and engagement. Anchoring prospective medical students to HSS prior to matriculating into UME could not only improve the receptivity of HSS among medical students but also afford applicants to medical school the opportunity to demonstrate how their own lived experiences will contribute to a more diverse school culture and physician workforce.

Methods Through a one-year academic record-enhancing postbaccalaureate premedical (PBPM) program, we introduced HSS to the 25 student cohort during their first biomedical science course and evaluated for curriculum feasibility and student satisfaction. The HSS thread incorporated asynchronous free online modules produced by a national group of HSS educators, followed by a required graded reflection at the end of the training. 

Results  Incorporating HSS into our PBPM program was well received by the postbaccalaureate students, as reported by 100% of student reflections and a desire to learn more about HSS. Students found HSS content easily relatable to themes in medicine, reported a clearer understanding of social determinants of health, and expressed increased motivation in becoming patient advocates by volunteering in our student-run free clinics, which we have implemented for the remainder of the program. We found our curriculum intervention feasible and appealing to students because the resources were publicly available, high quality, and validating of personal experience.

Conclusions We learned that pipeline PBPM programs provide an optimal environment to introduce premedical students to HSS content for many reasons: one that students are highly committed to becoming successful patient advocates before applying to UME, and another that pipeline PBPM programs are able to facilitate applied learning experiences through student-run free clinics.   

PRESENTATION 3 - Back to the Basics: a Course on Scientific Literature Critique as a Mechanism to Integrate Basic Science Concepts Into Clerkship Curricula    
Michelle Duffourc    
Quillen College of Medicine, East Tennessee State University 

PURPOSE Medical school curricular reforms designed to enhance learner integration of basic and clinical sciences have resulted in inclusion of clinically-oriented pedagogies into the preclerkship period and a shift towards earlier student immersion into the clinical environment. These changes have resulted in shorter preclerkship curricula, with concurrent decreases in student exposure to foundational science content. To ensure that graduating medical students have a sufficiently nuanced understanding of the scientific foundation of medicine, instructional methodologies to revisit or build upon foundational concepts during the clinical years are needed. But barriers to successful vertical integration include logistics and limited tools/strategies.

METHODS We designed a novel remote course for fourth year medical students entitled "Back to the Basics: Microbiologic Principles and Pharmacotherapy of Immunologic and Infectious Disorders". This course utilizes a combination of student-led patient case presentations, asynchronous basic science lectures, and journal club discussion sessions to reinforce how basic science concepts form the foundation of clinical decision making. Upon completion the students answered a survey to evaluate the strengths, weaknesses, and overall effectiveness of the course.

RESULTS The course received an average student evaluation of 4.11/5 on a Likert scale of 1 (poor) to 5 (excellent), though students suggested that the course be expanded to include more basic sciences topics. Students were particularly enthused to master a new skill (literature critique) and review high-yield basic science concepts prior to taking the STEP 2 CK exam. Faculty observers noted that all participants demonstrated increased ability to critique the primary literature and to explain the basic science underpinnings of their patient cases.

CONCLUSIONS Our novel literature-critique based course is a flexible and effective mechanism to promote integration of basic science concepts into the clerkship curriculum. It is easily adaptable to diverse curricular and instructional needs.

PRESENTATION 4 - Impact of a Community Service Learning Rotation on Student Interest in Working With Underserved Communities    
Kristin Bertsch    
Rowan University School of Osteopathic Medicine 

PURPOSE Community Service Learning and Leadership (CSLL) is a three-year curriculum designed to teach skills to work with New Jersey's medically underserved communities. Students are given the opportunity to utilize what they have learned over first and second years and apply this in their third year to the CSL rotation.  The AHEC site coordinators and the NJ Program Office assist student teams in identifying community-based agencies and health promotion projects. This study focuses on the CSL rotations required of third year medical students. This study sought to ascertain student's interest in working with underserved communities before and after the rotation.  

METHOD Pre/Post assessments were developed and given to all third year medical students who complete the rotation. The survey collects basic demographic information and data about respondents' intention to work with underserved populations. These results are compared to numbers in the post-test assessment, which is administered after the students complete the program.

RESULTS From 2017-2020, 535 students completed pre/post assessments. The post assessments revealed that 84.62% respondents answered 'yes' to the statement "I still personally want to be involved in providing care for the medically underserved during my medical career" after their rotation, an increase from 79.35% in the pre-survey data. Over 100 students are currently enrolled. About 82% of those surveyed indicated that they would like to serve in these communities. We expect the program will motivate more students to work in underserved communities.

CONCLUSION Students were more likely to want to work with underserved communities in their medical career after the rotation. This is consistent with prior research that shows that contact increases likelihood of working with underserved communities.