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Cognition before curriculum: rethinking the integration of basic science and clinical learning
Kulamakan Mahan Kulasegaram1, Maria Athina Martimianakis, Maria Mylopoulos
1Mr. Kulasegaram is a PhD candidate, Clinical Epidemiology and Biostatistics Program and Program for Education Research and Development, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada. He is also a Wilson Centre Fellow, University of Toronto, Toronto, Ontario, Canada. Dr. Martimianakis is director of scholarship, assistant professor, Department of Paediatrics, and scientist, Wilson Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Dr. Mylopoulos is assistant professor of paediatrics, University of Toronto, scientist, Learning Institute, Sick Kids Hospital, and scientist, Wilson Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Dr. Whitehead is vice chair for education, associate professor, Department of Family and Community Medicine, scientist, Wilson Centre, and education scientist, Centre for Ambulatory Care Education, Women's College Hospital, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Dr. Woods is assistant professor, Department of Surgery, and education scientist, Wilson Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Integrating basic and clinical sciences in medical education is challenging. Effective strategies focus on cognitive links between knowledge domains at the session level for better learning outcomes.
Area of Science:
- Medical Education
- Curriculum Development
- Cognitive Science
Background:
- Integrating basic science and clinical concepts is a key challenge in undergraduate medical education.
- Existing literature offers various integration strategies across different curriculum levels.
- Assessment of these integration strategies remains limited.
Purpose of the Study:
- To critically review and assess the literature on integrating basic science and clinical concepts in medical education.
- To identify effective strategies and contributing factors for successful integration.
- To evaluate the evidence base for different integration approaches.
Main Methods:
- A critical narrative review of literature published between 1982 and 2012.
- Analysis using a pre-established integration framework.
- Inclusion of studies documenting integration at program, course, or teaching session levels aimed at improving learning outcomes.
Main Results:
- Program and course-level integration strategies are described but inadequately evaluated.
- Successful integration is difficult to attribute to specific interventions due to multifactorial learning influences.
- Session-level interventions linking basic and clinical sciences causally show promise for integration.
Conclusions:
- Understanding integration as a cognitive process within learners is crucial.
- Learner-centered, content-focused, and session-level strategies can foster cognitive integration.
- Successful integration relies on learners building cognitive associations between basic and clinical sciences.
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