Clinical Immersions in the Basic Science Years: Bringing the Classroom to the Bedside

Derek Neilson*, Georgia Wiesner,  Eileen Seeholzer, Amy Wilson-Delfosse, Carol Chalkley, Terry Wolpaw, Siu Yan Scott, Dan Wolpaw, Case Western Reserve University, Cleveland, OH 44106-4929  U.S.A.

Purpose

Teaching of sciences basic to medicine remains the cornerstone of the first years of Medical School.  However, concentrated classroom activities present challenges to educators who strive to integrate experiential/contructivist learning theory and a culture of professionalism into the curriculum.  Long hours in the classroom without clear connection to clinical application encourages a “student” mentality, delays professional development, and promotes surface learning.  Early clinical preceptorships partially address this problem, but do not develop specific and meaningful contexts for science learning.  We implemented a series of “Clinical Immersions” to address this challenge.

Methods       

The WR2 curriculum features an integrated, student-centered approach to basic science education across five 12-week units of instruction, or “blocks”, with one week devoted to Clinical Immersion.  In this week students leave the classroom for five consecutive days late in the block, meeting patients and experiencing real-life applications linked to their scientific studies. Activities include patient interviews, simulation exercises, specialty clinics, operative and diagnostic procedures, laboratory correlations (pathology, cytogenetics, etc.), and community support groups, culminating in student-led presentations.. 

Results

Two immersion weeks are completed, with a third scheduled for May of 2007.  Student feedback is very positive, especially about the opportunity to develop meaningful contexts for science learning and the time to reflect and integrate.  Primary criticisms focus on wanting more clinical experiences within the immersion.

Conclusions/Future Directions

Clinical Immersions are a positive feature of the WR2 curriculum.  Challenges include expanding clinical experiences within immersion weeks and taking into account the professional development of students across the curriculum.