Spiralling Pre-clerkship Concepts into the Clinical Phase: Augmenting Knowledge Transfer Using Innovative Technology-Enhanced Curriculum Activities

BACKGROUND: Clerkship is a challenging transition for medical students where they learn to apply functional knowledge and diagnostic reasoning skills learned in the pre–clinical phase into the clinical environment. Rather than a smooth continuum to facilitate application of knowledge, clerkship blocks are discrete, fragmented structures with little integration. Developments in cognitive psychology and increasing attention to the student learning environment are driving more purposeful integration in medical education. We sought to enhance knowledge transfer in the Family Medicine clerkship by developing an e-learning pathway with both asynchronous and synchronous components to integrate pre-clerkship problem-based learning (PBL) cases into more complex clinical scenarios. METHODS: A parallel-convergent mixed methods evaluation was conducted, which included comparison of learning outcomes (exit exams) relative to the prior class, knowledge check quiz performance, and qualitative analysis of student and faculty perceptions. RESULTS: Analyses revealed no significant difference between exit exam scores of the intervention and pre-intervention clerks (p = 0.30). There were statistically significant differences in mean quiz scores over the rotation (p = 0.0001). Moreover, learners and faculty each perceived the integration components as facilitating the transfer of pre-clinical learning into clerkship activities. CONCLUSION: The novel e-learning pathway firmly anchored FM clerkship learning and will continue to ensure learners are ideally primed to optimize their direct clinical learning opportunities.