¹Medizinische Fakultät und Universitätsklinikum Dresden, TU Dresden, Medizinische Biologie, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Dresden, Germany
²Medizinische Fakultät und Universitätsklinikum Dresden, TU Dresden, Klinik für Viszeral-, Thorax- und Gefässchirurgie, Dresden, Germany
³Medizinische Fakultät und Universitätsklinikum Dresden, TU Dresden, Institut für Geschichte der Medizin, Dresden, Germany
⁴Medizinische Fakultät und Universitätsklinikum Dresden, TU Dresden, Medizinische Klinik I, Dresden, Germany
⁵Medizinische Fakultät und Universitätsklinikum Dresden, TU Dresden, Klinik und Poliklinik für Neurologie, Dresden, Germany
⁶Medizinische Fakultät und Universitätsklinikum Dresden, TU Dresden, Institut für Klinische Genetik, Dresden, Germany
⁷Medizinische Fakultät und Universitätsklinikum Dresden, TU Dresden, Institut für Allgemeinmedizin, Dresden, Germany
⁸Medizinische Fakultät und Universitätsklinikum Dresden, TU Dresden, Institut für Pharmakologie und Toxikologie, Dresden, Germany
⁹Medizinische Fakultät und Universitätsklinikum Dresden, TU Dresden, Institut für Didaktik und Lehrforschung in der Medizin, Dresden, Germany

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Background: In German medical curricula the preclinical phase is often mainly theoretical and not substantially connected to clinical practice. Contact with patients is rare, which could support the development of illness scripts. This results in students that might not fully comprehend the underlying pathophysiology of diseases as well as their diagnosis and treatment. In this study, we implemented clinical impulse lectures during biology classes in the first semester and evaluated their impact on knowledge, learning strategies and their sense of preparedness for clinical practice.

Methods: First-semester medical students received their regular biology curriculum enriched with up to 6 clinical impulse lectures including patient contact. Data was collected using pre- (n=227) and post-intervention (n=105) questionnaires assessing self-perceived biological and clinical knowledge. The influence of impulse lectures on learning motivation and strategy as well as on the connection between theory and clinical practice was analyzed. A test with 35 multiple-choice questions to objectively measure knowledge gain was done (n=71). Each clinical impulse was additionally evaluated by short questionnaires.

Results: Students felt substantially better in self-perceived preparedness regarding their biological knowledge for becoming physicians after attending the biology course. Also they significantly improved in self-assessed biology knowledge on a grading scale (baseline: 2.9 vs. final: 2.3, p<0.001, max. grade 1) as well as in clinical impulse-related knowledge (baseline: 3.3 vs. final: 2.5, p<0.001, max. grade 1). The integration of clinical impulse lectures highlighted the relevance of scientific foundations for clinical practice and motivated students for integrated learning. There was a positive correlation with the number of clinical impulses received. The concept of vertical integration was positively evaluated with over 80% agreement. The objective assessments through multiple-choice questions demonstrated higher scores for biology topics in students that received more clinical impulse lectures.

Conclusion: The findings suggest that early clinical impulses, i.e. a first step of vertical integration, improve both subjective and objective learning outcomes and are well-received by students.