Novel case‐based learning approach to integrate basic and clinical sciences

We propose a novel strategy applicable to case‐based learning during the initial years of a medical curriculum. Step 1 presents a clinical vignette that requires students to obtain additional information. Step 2: Students are provided access to an on‐line database containing results of physical exams (PE). Students must pay “PE bucks” to obtain additional findings. The number of “PE bucks” provided to the students is less than the total cost of all possible physical exams. Step 3: The same strategy described above for physical exams is applied to choosing procedures or laboratory tests. The decision to order procedures, laboratory tests, or physical exams depends upon their expense, complexity, and availability. This concept is made more concrete by incorporating “lab bucks” and “PE bucks” as tangible assets. The aforementioned steps help students develop decision‐making processes that address competencies such as relationship‐centered care and systems‐based practice. Step 4: Basic and clinical science faculty serve as content experts to facilitate discussion of multiple choice questions focusing on the basic science or clinical training. This teaching strategy prepares students to integrate basic sciences with clinical situations and should be extremely useful in preparing students for upcoming revision of USMLE Step 1‐Step 2.