Synthesis Across Disciplines: Creating Integrated Clinical Vignettes for Pre-clerkship Medical Training

Case-based learning strategies have been shown to enhance student engagement, promote active learning, and improve problem-solving ability by simulating clinical scenarios. However, few interventions focus specifically on integration within basic science domains, and even fewer have been student-led and implemented longitudinally throughout a pre-clerkship curriculum. This study evaluates the impact of a student-led initiative that incorporated interdisciplinary clinical vignettes into first-year medical coursework at a large allopathic medical school in the United States.

Vignettes were designed to align with curricular themes across anatomy, histology, and pathology for each of the 13 curricular blocks. First-year medical students completed post-intervention surveys measuring confidence in applying course material, integration between concepts, and perceived relevance of the vignettes.

Across all blocks of vignettes, the majority of respondents agreed that the vignettes allowed them to think about lecture material in a new way (98%; 57% strongly agree, 41% somewhat agree), felt relevant to current material (95%; 73% strongly agree, 22% somewhat agree), and related the concepts from their anatomy, pathology, and histology courses (94%; 69% strongly agree, 25% somewhat agree). The analysis of our survey data confirms that students' confidence in exam material increased after the use of the clinical vignettes. This was statistically significant for every discipline and across the vast majority of blocks.

Integrated vignettes fostered interdisciplinary learning and improved confidence in applying pre-clerkship knowledge across disciplines. This low- resource, peer-led model may serve as an adaptable tool to support early clinical reasoning and integrative learning across foundational science curricula.