TCU/UNTHSC School of Medicine Grand Rounds–Dr. Leslie Fall

Grand Rounds: “Deepening Cognitive Integration of Basic Science and Clinical Medicine to Support Effective Decision-Making and Entrustment” with Dr. Leslie Fall

Tuesday, February 18, 2020
7:30 AM – 8:30 AM
LIB 110

Presentation Summary:
Innovative curricular models are needed to help learners thrive in 21st-century healthcare. One of the primary roles of medical training programs is to ensure learners develop medical decision-making skills, and to do so with graduated levels of independence. Effective cognitive integration of the basic and clinical science concepts plays an essential role in enhancing diagnostic accuracy and clinical decision-making for novice clinicians. Unfortunately, many students who have demonstrated adequate basic science understanding in the pre-clinical curriculum are often unable to apply this knowledge to clinical problem-solving. This problem often stems from systems-based preclinical teaching that does not adequately support the deeply integrated thinking required in everyday medical practice. Additionally, the basic science understanding of clinical preceptors is often encapsulated, challenging the ability of these faculty to advance learners’ integration of basic and clinical science understanding to justify their clinical decisions. Curricular methods for integrating basic science instruction and for “unpacking” preceptor knowledge and reinforcing its connections to clinical decisions would facilitate learner activation of basic science knowledge, improving both diagnostic accuracy and long-term retention. In return, learners who are able to apply basic science concepts and mechanistic understanding to defend their clinical decisions may improve the clinician preceptor entrustment decisions. In these sessions we will explore new evidence-based teaching methods and learning tools to deepen cognitive integration of basic science into clinical practice to entrust better decision-making. These methods have the power to re-engineer the teaching relationship between basic science and clinical faculty towards the mutually held goal of improving the safety and efficacy of patient care provided by our students.

By the end of the sessions, participants will be able to:
1. Explain the concepts of knowledge organization, cognitive integration and encapsulation;
2. Identify curricular and environmental barriers limiting students’ ability to effectively transfer basic science understanding to clinical practice;
3. Use integrated illness scripts and mechanistic diagrams to unencapsulate and integrate faculty teaching and to assess and advance students’ clinical problem-solving skills:
4. Discuss the importance of cognitive integration to patient care entrustment decisions.