Purpose
Problem-based learning (PBL), though resource intensive, is an enticing active learning methodology in medical education as it is more effective than traditional methodologies in improving problem-solving, communication, and self-directed learning skills while still providing high-quality basic science content. Developing high-quality PBL cases across a foundational curriculum requires a delicate balance of deep science knowledge and clinical experience as well as seamless collaboration across many faculty stakeholders and students.

Methods
19 PBL cases were successfully integrated into each of a series of 10 system-based courses in a 16-month preclinical curriculum across two campuses. A wide breadth of topics from biochemistry to public health were encompassed in a concise set of 8-12 learning objectives and built into a clinical case narrative. PBL sessions consist of three days. On day one, students work through the case and identify learning issues followed by a 48-hour minimum pause for student research; cases conclude with a case presentation, finalization of a team concept map, and peer teaching.

Results
In order to support the successful integration of PBL cases into 10 foundational courses, the following effective practices were developed: 1) PBL directors were appointed to coordinate faculty across courses and provide consistently presented and formatted, high-quality PBL cases. 2) All course directors across 10 courses received training and support in the development and revision of their PBL cases. 3) All facilitators and students received training in the PBL process and grading expectations. 4) PBL learning objectives were aligned to appropriate assessment types. 5) Attendance policies were put in place to model medical professionalism expectations.

Conclusion
Effective integration of high-quality PBL cases in a foundational curriculum requires leadership investment, intentional design, faculty engagement, training for all stakeholders, and consistent implementation.