Purpose
First-year students at the University of Illinois Urbana-Champaign Carle Illinois College of Medicine begin their curriculum with a six-week survey Foundations Course covering multiple foundational science disciplines, before transitioning into an integrated organ-systems curriculum. Students often struggle to adapt to an integrated model requiring the application of basic science knowledge to clinical reasoning. To ease this transition, we created a Foundations course culminating activity utilizing a multisystem disease model for Cystic Fibrosis (CF) where students use a Mechanism of Disease (MoD) Map to explain how various foundational sciences concepts are integrated into the disease mechanisms underlying its clinical presentation(s), diagnosis and treatment.

Methods
Our MoD-Map activity was based on integration tools developed by Aquifer Sciences (Fall, et. al., 2021). The two-hour session began with an interactive lecture introducing CF and its relevant foundational science. Students next worked in teams of 5-6 to develop a MoD Map examining basic science mechanisms underlying etiology, epidemiology, pathogenesis, and clinical presentation of CF. To culminate the activity, each team shared their map and explained how their specifically assigned foundational science discipline contributed to the mechanism of disease, diagnosis, and/or treatment of CF. Each team subsequently submitted a digital copy of their MoD map.

Results
The small-group model worked well for MoD Map creation and subsequent peer-teaching of seven discipline-specific aspects of CF, five organ-system clinical phenotypes, and their treatment. Despite groups using common triggering events (genetics/biochemistry), variations were observed between the depths of mechanisms presented and how they were labeled by discipline. Student engagement was high and produced artifacts demonstrating cognitive integration of basic and clinical sciences.

Conclusions
This work demonstrates the utility of early introduction of integrative exercises in medical curricula using tools such as MoD maps that teach students how to start applying basic science concepts to organ system pathologies, thus building an understanding of the clinical relevance of the foundational sciences.