Foundational and Clinical Science Integration in a Team-Based Learning Module Modeling Care of a Patient With Dyslipidemia

Introduction

Foundational and clinical science integration, a long-standing goal of undergraduate medical education, benefits learners by promoting retention of critical knowledge and skills as well as their transfer to the clinical setting. We implemented a team-based learning (TBL) module in which foundational knowledge and skills from the disciplines of biochemistry, nutrition, and genetics were leveraged in a simulated patient encounter for diagnosis and management of a patient with dyslipidemia.

Methods

The TBL was deployed in a first-year medical student cardiovascular system course with 125 students over three academic years. Following individual and team readiness assurance tests (iRAT and tRAT, respectively), teams participated in an initial application exercise requiring consideration of clinical and laboratory data and other risk factors to engage the patient in a shared decision-making process. Using dietary and family history narratives in subsequent application exercises, teams completed recommendations for an individualized diet plan and an assessment of potential disease inheritance patterns to formulate appropriate patient care management strategies.

Results

Student engagement with prelearning materials and session team activities was high as judged by RAT performance and application exercise outcomes: iRAT question performance ranged from 89% to 99% for individual items, and tRAT performance was routinely 100%. Learners reported that the exercises were impactful and believed the learned foundational knowledge and skills were transferable to future patient care.

Discussion

The dyslipidemia TBL module provides an illustration for early clinical learners of how foundational knowledge and skills can be operationalized and transferred for optimal patient care.

Livogena: The Ikteros Curse-A Jaundice Narrative Card and Board Game for Medical Students

Introduction

Jaundice is a common condition that requires integrating knowledge of biochemistry, physiology, pathology, and general medicine. However, medical students face difficulty in learning with passive teaching methods. To enhance their learning, an educational story game that promotes active learning and assessment with immediate feedback was implemented.

Methods

This jaundice game was named Livogena: The Ikteros Curse-denoting the liver as the principal organ and jaundice (icterus) as a problem. One hundred fifty first-year medical students were divided into small groups to play using a game board and cards. The players moved ahead on the game board by providing the correct answer and completing the activities. The first team to reach the end was the winner. Perceptions and feedback questionnaires were distributed to students at the end of the game. Individual views about the game were recorded for qualitative analysis. Also, to analyze the effectiveness of this intervention, pre- and posttests on jaundice were conducted.

Results

Livogena: The Ikteros Curse resulted in a highly significant improvement in students' knowledge and application skills in jaundice, from 5.5 (SD = 2.4) in the pretest to 11.2 (SD = 7.6) in the posttest for 20 marks (p < .001). Students perceived and rated the game exceptionally positively.

Discussion

This educational game significantly increased learners' understanding of the concepts of jaundice. Highly positive perceptions from students further affirm this to be a creative innovation to enhance their learning and application of knowledge in an active and team-based learning environment.

Genetic Testing and Counseling in Metabolic Liver Disease: An Interactive Lecture for Medical Students

INTRODUCTION

Medical students have limited opportunities to learn about current genetic testing. This session provided exposure to different types of testing and the complex issues that physicians may encounter when counseling patients on proper testing and interpreting results.

METHODS

We designed a 1-hour interactive lecture for second-year medical students. We presented an overview of the topic, then applied the concepts to specific disorders and cases. Students were asked to answer questions regarding cases using an audience response system, and we used their responses as the basis for our in-class discussion. This session has been held twice, with 25 students attending in 2018 and 31 students in 2019. The session was also recorded so that additional students not in attendance could watch, and was available to 151 students in 2018 and 333 students in 2019.

RESULTS

Students answered questions via audience response system. There was a range of 47%-100% of students giving the correct answers in 2018, and 55%-93% in 2019. Exam questions covering genetic counseling issues were answered correctly by 66% and 77% of students in 2018, and 70% and 68% of students in 2019.

DISCUSSION

This session provided an opportunity for medical students to be exposed to some of the complex ethical and psychosocial issues that may arise with genetic testing for liver disease and to consider how to navigate them. Using an audience response system during the lecture made the session more interactive and allowed the teacher to correct errors and teach based on the responses.