JIAMSE © IAMSE 2004 Volume 14 # 34 A Collaborative Strategy for Reciprocal Integration of Basic and Clinical Sciences Edmund H. Duthie, Jr., M.D. 1 , Deborah Simpson, Ph.D. 2 , Karen Marcdante, M.D. 2 , Diana Kerwin, M.D. 1 , Kathryn Denson, M.D. 1 , and Mary Cohan, M.D. 1 1 Department of Medicine, Division of Geriatrics / Gerontology Medical College of Wisconsin VAMC -Milwaukee (CC-G) Milwaukee, Wisconsin 53295 U.S.A. 2 Office of Educational Services Medical College of Wisconsin Milwaukee, Wisconsin 53226 U.S.A. Phone: (+)1-414-384-2000 x 42775 Fax: (+)1-414- 382-5376 Email: eduthie@mcw.edu ABSTRACT Geriatric patient cases are ideal for use by basic science educators who seek to link key principles and concepts with clinical medicine. However, access to geriatric educators and geriatric patients able to highlight the evolution of a particular disease/condition, limits the basic science educator’s ability to easily incorporate clinical cases into their teaching. To address this resource limitation, we developed five core geriatric clinical cases, each portraying a patient who ages over time, for repeated use in multiple courses/clerkships across the four-year medical student curriculum. In this article, we describe the process involved in designing the cases with illustrative examples of their use in selected basic science courses. Guided by John Kotter’s change process, the project team sponsored a series of invitational workshops composed of basic science and clinical educators whose expertise was related to the patient under review. At each workshop, an abstracted patient record was presented (e.g., longitudinal history, physical exam, laboratory data, and diagnostic images), and participants modified the case to better highlight teaching points associated with their respective courses/clerkships. Each updated case was then circulated to all workshop attendees, and other educators across the curriculum, for incorporation into their instruction. The flexibility of each case enables faculty to use the case(s) in varied settings (e.g., lectures, problem based learning groups, labs) matched to the objectives, resulting in students having a longitudinal experience with five geriatric patients and their diseases. The cases continue to be incorporated into the curriculum with students reinforcing the value of their inclusion as they follow the patient’s diabetes and its progression through biochemistry, physiology, surgery and medicine. In summary, Kotter’s change steps effectively guided the project team and can serve as a model for educators seeking to enhance reciprocal integration of basic and clinical sciences. INTRODUCTION Basic science educators have sought to link the principles and concepts of their disciplines with clinical medicine by implementing multiple basic science curriculum structures (e.g., organ-based, discipline-based, key features/problems) and formats (e.g., problem-based learning, clinical correlations, simulations, lectures, laboratories). Yet, only 12% of the 2003 graduating seniors surveyed via the Association of American Medical Colleges (AAMC) Senior Graduation Questionnaire 1 strongly agreed that basic science content had sufficient illustrations of clinical relevance and provided relevant preparation for their clerkships. Simultaneously, clinical educators struggle to facilitate the incorporation of specific topics or populations into the curriculum. For example, because geriatric patients are a critical population in medicine, Dr. Robert N. Butler, the first Director of the National Institutes on Aging, was an early advocate for the exposing medical students to geriatric medicine topics and clinical concepts throughout the medical school curriculum. 1 With funding awarded through AAMC/John T. Hartford Foundation, over 40 U.S. medical schools have introduced geriatrics educational initiatives spanning all four years of the curriculum. The opportunity to integrate clinical geriatrics and basic science is readily apparent as 85% of geriatric patients have at least one chronic illness, most commonly arthritis,