Using Longitudinal Fabricated Patient Panels to Integrate Clinical and Basic Science Education in a Spiraled Preclinical Medical Curriculum
Authors: Osborne David L. , Howell Sherri J. , Bramblett Debra E. , Minugh‐Purvis Nancy , Galin Claire M. , Selinfreund Richard H. , Vilchis Hugo , Ketchum Robert J. , Rodenbaugh David W. 
Published: November 2023

The use of clinical case material is not novel. Case presentations have been used by basic scientists to provide clinical context. Clinical educators have used simulations and clinical presentation to teach and test the progress of medical student clinical reasoning. How can we expect medical students to integrate material when the cases utilized are presented in a haphazard and disconnected fashion? In the quest to not only integrate basic and clinical sciences for medical students, but also promote medical competencies, using longitudinal fabricated patients extends the value associated with the inclusion of cases by instructors. At Burrell College of Osteopathic Medicine, faculty have been planning an organ system based spiral curriculum. During curricular planning, faculty were concerned with the lack of continuity between case‐related materials. The concept of using longitudinal fabricated patient panels evolved from these initial meetings. A panel of longitudinal fabricated patient cases provides a ready list of clinical patients and associated conditions that the basic and clinical science instructors can utilize throughout courses. The students maintain and modify medical records on these patients as the curriculum progresses and clinical cases evolve. Thus, cases promote clinical relevance for basic science faculty while providing opportunities to teach communication, documentation and medical record management by the clinical faculty. Each patient is introduced to the students as an initial visit to the clinic to be seen by the doctor (medical student). The patients present with initial vital information, history and a set of symptoms that may relate to pre‐identified acute or chronic ailments related to the current organ system being taught. Students need to add new patients to their personal record system or update previous patient's records if new information is presented on a former patient. These patient files span the first two years of the curriculum and are used to demonstrate related or unrelated clinical issues over time. For example, in the first year gastrointestinal course, a patient will be introduced to the class having gastroesophageal reflux disease (GERD). GERD can be the platform to discuss smooth muscle function, its protective roles, as well as regulation of acid release or other basic science concepts. In the second year gastrointestinal course, this same patient can “return to the clinic” presenting with difficulty swallowing and subsequent diagnosis of adenocarcinoma secondary to Barrett's esophagus. The pathologist can now relate this back to the progression of chronic GERD. The clinical faculty can also discuss diagnosis, progression of the disease and risks of malignancy with respect to patient education and adherence to clinically recommended alterations in lifestyle and/or pharmacotherapies from year one. Additionally, these patient panels provide opportunities to address cultural competencies and psycho‐social awareness with students. Given the Osteopathic Medicine tenet “the body is a unit; the person is a unit of body, mind and spirit”, the fabricated longitudinal patient panels provides a continual platform for both horizontal basic science discipline integration with vertical clinical medicine integration. Furthermore, these longitudinal cases promote student appreciation of the person by including cultural attributes and psycho‐social parameters that become apparent over time.