Students' Perspectives on Basic and Clinical Science Integration When Step 1 is Administered After the Core...

Area of Science:

• Medical Education
• Cognitive Science
• Curriculum Development

Background:

• Adult learning theories suggest integrating basic and clinical sciences improves knowledge transfer to patient care.
• The U.S. Medical Licensing Examination (USMLE) Step 1 placement after clerkships aims to enhance this integration.
• Learner experiences with this curriculum model remain largely unexplored.

Purpose of the Study:

• To explore senior medical students' perspectives on integrating basic and clinical sciences.
• To understand the impact of a post-clerkship USMLE Step 1 curriculum on cognitive integration.
• To identify facilitators and barriers to knowledge integration in medical training.

Main Methods:

• Conducted focus groups with senior medical students from two U.S. medical schools.
• Utilized a constructivist approach to thematic analysis of qualitative data.
• Interviewed 33 students across six focus groups.

Main Results:

• Students reported barriers to integration, including weak basic science foundations and perceived irrelevance.
• Facilitators included explicit connections made by educators and application-focused learning activities.
• The dedicated USMLE Step 1 study period provided significant integration opportunities.

Conclusions:

• Barriers to basic and clinical science integration exist within post-clerkship Step 1 curricula.
• Explicitly demonstrating basic science relevance to patient care is crucial for effective integration.
• The post-clerkship Step 1 study period offers a valuable window for cognitive integration and knowledge transfer.