Medical education has progressively moved towards curricula that feature concept-based courses, decreased lecture time, discipline integration, and increased small-groups with active learning. In response many medical schools have developed integrated courses where medical genetics is integrated with biochemistry, cell biology or both. An additional challenge is to provide clinical relevance to the basic science curriculum. Medical students are also challenged with a transition in learning and problem solving. Traditional lecture courses provide information and the problem solving is in the form of an examination. The medical encounter is characterized by the presentation of the problem (undiagnosed disease) followed by information gathering (reading and consultation with peers) and finally a synthesis of a large amount of material into a concise synopsis (treatment and explanation to the family). At the Pritzker School of Medicine the Cells, Molecules, and Genes (CMG) course, which integrates three previous independent courses (biochemistry, cell biology and medical genetics), addressed these principles and challenges through extensive utilization of small-group discussions using a novel case-based format.

To facilitate small group discussion and self-based learning, the curriculum of CMG was designed around 9 clinical cases all with a genetic etiology. The cases were selected based on the specific disrupted cellular mechanisms underlying the diseases to illustrate principles of biochemistry, cell biology and genetics.  Each case was presented by a clinician who focused on a single patient and included a complete medical history and diagnosis. After the presentation, the class split into prearranged small groups of 8-9 students together with a discussion facilitator, and spent two one-hour sessions discussing the case over the next 3-4 days. In the first session, groups were charged to develop hypotheses to explain the fundamental cellular or molecular processes underlying the disease phenotype. During this initial session, students were not allowed to use the internet or other outside resources in developing their hypothesis. In addition to the hypotheses, the groups prepared a series of questions relevant to the hypotheses to be answered prior to the second discussion. In the second session, the groups reconvened and, utilizing information from self-study, lectures, and other course material, assessed the original hypotheses and provided final closure to the case. Overall, the case presentation and discussion format was designed to model physician learning by presenting the problem first (patient presentation of disease) and challenging students to assimilate large amounts of information from diverse sources (lectures, workshops and independent reading) to resolve a clinical case from the perspective of the basic science components of biochemistry, cell biology and genetics.

The course also utilized workshops that included small group presentations (journal clubs, etc.) and group problem solving of clinical application of the basic science material. In addition team based learning exercises were used to integrate the metabolic pathways of biochemistry (one example is a alcoholic man who presents with hypoglycemia and ketosis). 

The format allows students to examine their own knowledge base, communicate with their peers, develop critical thinking skills, and assimilate information from many different sources.

This poster (#400) will be presented at the ACMG Annual Meeting by Darrel Waggoner, M.D.,  our Medical Director, Friday March 30: 10:30-11:30 am. Stop by and learn more.