Feasibility of a Vertically Integrated Teaching Strategy during a Surgical Clerkship Event-Learning Methods Matter

• Main Authors: Miklos C. Fogarasi (Author), Christine Van Cott (Author), Richard S. Feinn (Author), Steven A. Hirshorn (Author), Eugene H. Lewis (Author), Susan V. Fernandez (Author), Lori Ratchelous (Author), Julia A. O'Connor (Author), Larry D. Gruppen (Author)
• Format: Book
• Published: MDPI AG, 2022-08-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.3390/educsci12080557; 2227-7102
• Keywords: medical education; vertical integration; cancer workshop; case-based collaborative learning; clinical clerkship; Education; L
• Source: Education Sciences, Vol 12, Iss 8, p 557 (2022)

Sound foundational knowledge improves disease conceptualization and clinical diagnosis. Vertical integration (VI) is an appealing educational strategy to refresh relevant pre-clinical information during clinical rotations. However, an optimal learning approach for this has not yet been established. We hypothesized that a small group collaborative discussion format might serve as an appealing learning method to deliver integrated material and increase retention. During AYs 2018/2019 and 2019/2020, our multidisciplinary team utilized a Colorectal Cancer workshop incorporating pre-clinical material for Y3 students on Surgical Clerkship. In search of an optimized way to deliver vertically integrated content, we alternately presented the workshop material either in a small group (SG) case-based collaborative format or as a standard-sized group (StdG) exercise. We achieved this by testing immediate and late (4-week post-event) recall and assessing student satisfaction with the VI strategy in both physical settings (StdG and SG). A total of 93% of participants considered VI-based training worthwhile, 96% reported an increased knowledge base and 93% would welcome similar VI events in the curriculum. Significantly more SG students than StdG (52% vs. 31%, <i>p</i> = 0.014) enthusiastically endorsed their event and would prefer to have future VI events delivered in the format they experienced (88% for SG vs. 42% for StdG) (<i>p</i> < 0.0001). Combined (immediate + late) recall scores were significantly better in SG versus StdG (<i>p</i> = 0.007), while the <i>rate</i> of attrition at 4 weeks did not differ significantly (<i>p</i> = 0.81). VI strategy successfully reactivated pre-clinical concepts, achieving both high content retention and learner satisfaction during this workshop. Students endorsed future VI events, especially when delivered in a case-based, interactive SG setting. Although resource intensive, a VI strategy employing a small-group collaborative learning method may be considered for broader curricular use in undergraduate medical education.