Theme: Basic Sciences and Clinical Integration
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Teaching clinically relevant basic science knowledge
Authors: Antonia Pelz
Schulze-Luckow A.
Peters H.
Pelz J.
Institutions:
 
Background

In the traditional curriculum of the Charité (Berlin) like in all traditonal curricula in Germany basic sciences are taught acccording to the H-Model, during the the two preclinical years. This is believed to lay ground for a scientific understanding of ailments and to foster abilities for clinical reasoning and decision making during the clinical years.

Summary of Work

With the guidance and input of faculty specialists we developed a structured questionaire with open questions about basic science knowledge of blood, heart, kidney, liver and lung. These questions covered basic science facts that every student should know by heart when he starts to work in one of these specialties during his practical year. The content was thought to be relevant and essential basic science knowledge which is important for clinical thinking..
Expected subject matter of the answers was predefined and a potential maximum of ratings was determined.
90 of our 5th year students (about one third of the semester) participated voluntarily in this study - the could use as much time as they needed to complete the questions. The test was conducted under examination conditions. Students were asked to assess each question according to 'comprehensibility' and 'clinical usefulness'.

Conclusion

Preclinical students are confronted with an encyclopedic amount of basic science facts. It is imposible for them to assess the clinical relevance of all this information. They cannot decide what is essential 'core knowledge' and what is 'nice to know' but peripheral. Their teachers don't provide guidance: everything of their fíeld of knowledge is 'impotant'. What students remember about the preclinical teaching are curious, fantastic lessons and enthusiastic teachers - irrespective of content. Waters of forgetfulness are a random process. Instructors of basic sciences shoul try to assure that students know by heart those facts and principles that are relevant during the clinical years. 

In the details you find the relationship between the results of the written and the oral preclinical examination (First State Examination covering the basic sciendes) and the results of the present study - core basic sciences. There is a slight relation between the written test and our study and a negligible relation between the oral test and the results of the present study.

Take-home Messages

Less but clinically relevant basic science knowledge is more than encyclopedic matters of low importance.

Summary of Results

 Table 1: Testresults

 

Subject area Potential maximum (number of points) Actual yielded maximum of points % Mean value of yielded points %
Blood 41 34 83 17 41
Heart 32 31 66 12 38
Kidney 60 39 65 22 37
Liver 30 21 70 11 49
Lung 35 31 89 17 37


 There is a striking difference of possible maximum of points - which is the expected result that every student should reach (basic core knowledge) and the average number of points reached in this study which is about 40% of the expected knowledge. 

 Students judged each question according to "comprehensible" and "clinically meaningful" on a scale from 1 (low) to 5 (high). The averrage values are given in Table 2.

Table 2: Quality of questions (student's judgement)

 

Subject area coprehensible >=3 clinically meaningful >=3
Blood 93% 94%
Heart 88% 95%
Kidney 91% 87%
Liver 94% 92%
Lung 93% 92%

 

Students took their time for the completion of the test - between one and three hours. The invested amount of time didn't pay off for all participants.

Background

 

 After the two preclinical years students have an examination that comprises a written and an oral part.

Content of the examinations is 

Basic Sciences:

- Physics and Physiology for medical students
- Chemistry, Biochemistry and Molecular Biology for medical students
 
- Biology and Anatomy for medical students
- Basics in Medical Psychology and Medical Sociology

There are 1449 hours of teaching during the two preclinical years for the basic sciences - this is ~ 40% of the teaching time during the five years in the university.

   
   
 

 

 

 

 


 

Summary of Work
Conclusion

Take-home Messages
Summary of Results

 

 

 

 

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