PURPOSE
Pathology often loses visibility in organ-based integrated curricula,
making it difficult for students to connect histology, anatomy, and clinical
reasoning. This study introduces the SCENT framework—Scenario, Context,
Expected, Noticed, Tale—a structured pedagogical tool designed to
systematically embed pathology into integrated cases. The aim was to evaluate
its initial implementation and student adoption within a pre-clerkship active
learning curriculum.
INNOVATION
SCENT offers a five-step reasoning structure guiding students from patient
presentation to clinical synthesis. It was introduced to 49 first-year
medical students prior to their first organ systems course and deployed via
structured worksheets in OneNote Class Notebook, with embedded virtual
microscopy slides for independent use. The pilot included 12 endocrine
pathology cases (8 thyroid, 4 adrenal), with planned expansion to over 40
cases across organ systems over 18 months.
OUTCOMES/CHALLENGES
In the endocrine course, 49% of students (24/49) engaged independently with
SCENT thyroid cases, adding histology images and personal notes beyond
assigned prompts. During an optional gross pathology session, 10 of 21
attendees spontaneously applied SCENT to identify thyroidectomy specimens,
demonstrating transfer of reasoning from digital cases to physical specimens.
Full cohort data will be collected through end-of-course evaluations and
focus groups.
CONCLUSIONS
SCENT solidifies pathology’s presence in integrated curricula by offering a
systematic structure that students internalize as a cognitive tool. Early
implementation shows feasibility for scalable rollout. Student-driven
application—from digital engagement to spontaneous use with
specimens—demonstrates SCENT’s evolution from teaching aid to reasoning
strategy. Its modality-agnostic design supports deployment across lectures,
flipped classrooms, and independent learning, making it a versatile solution
for scalable pathology integration – and potentially adaptable to other
foundational disciplines such as physiology, biochemistry, and genetics.