Improving Medical Students' Application of Knowledge and Clinical Decision-Making Through a Porcine-Based Integrated Cardiac Basic Science Program.
OBJECTIVE
Despite the concerted effort of modern undergraduate curriculum designers, the ability to integrate basic sciences in clinical rotations is an ongoing problem in medical education. Students and newly qualified doctors themselves report worry about the effect this has on their clinical performance. There are examples in the literature to support development of attempts at integrating such aspects, but this "vertical integration" has proven to be difficult. We designed an expert-led integrated program using dissection of porcine hearts to improve the use of cardiac basic sciences in clinical medical students' decision-making processes. To our knowledge, this is the first time in the United Kingdom that an animal model has been used to teach undergraduate clinical anatomy to medical students to direct wider application of knowledge.


METHODS
Action research methodology was used to evaluate the local curriculum and assess learners needs, and the agreed teaching outcomes, methods, and delivery outline were established. A total of 18 students in the clinical years of their degree program attended, completing precourse and postcourse multichoice questions examinations and questionnaires to assess learners' development.


RESULTS
Student's knowledge scores improved by 17.5% (p = 0.01; students t-test). Students also felt more confident at applying underlying knowledge to decision-making and diagnosis in clinical medicine. An expert teacher (consultant surgeon) was seen as beneficial to students' understanding and appreciation.


CONCLUSIONS
This study outlines how the development of a teaching intervention using porcine-based methods successfully improved both student's knowledge and application of cardiac basic sciences. We recommend that clinicians fully engage with integrating previously learnt underlying sciences to aid students in developing decision-making and diagnostic skills as well as a deeper approach to learning.
Academic Unit of Medical Education, The Medical School, The University of Sheffield, Sheffield, United Kingdom. Electronic address: martyn.stott@nhs.net.
Martyn Charles
MC
Stott
Academic Unit of Medical Education, The Medical School, The University of Sheffield, Sheffield, United Kingdom.
Michael Richard
MR
Gooseman
South Yorkshire Cardiothoracic Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Sheffield, United Kingdom.
Norman Paul
NP
Briffa
D000715:Anatomy / Q000193:education*; D000818:Animals; D002309:Cardiology / Q000193:education*; D000066491:Clinical Decision-Making; D003479:Curriculum; D004195:Disease Models, Animal; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D006801:Humans; D017145:Models, Educational; D020380:Needs Assessment; D013552:Swine; D006113:United Kingdom
Medical Knowledge; Practice-Based Learning and Improvement; Systems-Based Practice; application; cardiac sciences; cardiothoracic surgery; clinical anatomy; clinical decision-making