Presented By: John Szarek, Geisinger Commonwealth School of Medicine
Co-Authors: Devon Bremer, Geisinger Commonwealth School of Medicine
Igor Danelisen, Geisinger Commonwealth School of Medicine
Jennifer Koestler, Geisinger Commonwealth School of Medicine
Brytanie Marshall, Geisinger Commonwealth School of Medicine
Ashley Shamanskyu, Geisinger Commonwealth School of Medicine
Shubhra Shetty, Geisinger Commonwealth School of Medicine
Margrit Shoemaker, Geisinger Commonwealth School of Medicine
Gabi Waite, Geisinger Commonwealth School of Medicine
Jennifer Zangardi, Geisinger Commonwealth School of Medicine

Purpose
Medical schools are designing their curricula to provide students with earlier entry into clerkships. Systematically linking foundational science (FS) to patient care across the curriculum can enhance cognitive integration and recall. While having a strong FS foundation is crucial to the practice of medicine, there is no universally accepted standard for integration of FS across the MD Program. The purpose of our innovation is to ensure this linkage through deliberate augmentation of students' perception of FS during their clinical phases. 

Methods 
In renewing our curriculum, FS faculty were deliberately paired with core clinical education faculty. Teams worked together to design both pre-clerkship and clerkship sessions. Integration methods utilized included interactive didactics, gamification, case discussions, and quizzes. To enhance the visibility of FS integration, we used a symbol derived from our school's curriculum logo to emphasize FS integration to students during the individual sessions. 

Results 
Questions related to quality and satisfaction with FS integration were added to end-of-clerkship evaluations. Preliminary results demonstrate that students acknowledge FS integration across the rotations (94% strongly agree/agree). Moreover, in one clerkship, students' performance on comprehensive FS quizzes (83%±0.03%) was comparable to scores on clinical quizzes. Additional results, including cohort performance on formative assessments, subject examination performance related to FS application, and longitudinal trends in the AAMC GQ will be available by the time of the conference. 

Conclusions 
Strengths include cross-phase collaboration among FS and clinical faculty and clear labeling of FS integration. Limitations to FS integration include the nature of the workplace, time pressures, and faculty skill set. This innovation is both feasible and transferable. The deliberate pairing of FS and clinical faculty promotes teamwork and ensures coordination of FS across phases. Using an institutional logo to denote FS integration requires little effort and, together with the intentional pairing of faculty, enhances cognitive integration.