Vertical integration of clinical knowledge in preclinical medical education: assessing the impact on the first-year biology curriculum in a German medical school
10 affiliations
- 1Division of Medical Biology, Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus at TUD Dresden University of Technology and Faculty of Medicine of TUD Dresden University of Technology, Dresden, Germany
- 2Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus at TUD Dresden University of Technology and Faculty of Medicine of TUD Dresden University of Technology, Dresden, Germany
- 3Institute for History of Medicine, Faculty of Medicine of TUD Dresden University of Technology, Dresden, Germany
- 4Department of Medicine I, University Hospital Carl Gustav Carus at TUD Dresden University of Technology and Faculty of Medicine of TUD Dresden University of Technology, Dresden, Germany
- 5Department of Neurology, University Hospital Carl Gustav Carus at TUD Dresden University of Technology and Faculty of Medicine of TUD Dresden University of Technology, Dresden, Germany
- 6Institute for Clinical Genetics, University Hospital Carl Gustav Carus at TUD Dresden University of Technology and Faculty of Medicine of TUD Dresden University of Technology, Dresden, Germany
- 7Department for Primary Care - Family Medicine, Medical University Lusatia – Carl Thiem, Cottbus, Germany
- 8Department of Family Medicine, University Hospital Carl Gustav Carus at TUD Dresden University of Technology and Faculty of Medicine of TUD Dresden University of Technology, Dresden, Germany
- 9Institute for Pharmacology and Toxicology, Faculty of Medicine of TUD Dresden University of Technology, Dresden, Germany
- 10Institute of Medical Education, Faculty of Medicine of TUD Dresden University of Technology, Dresden, Germany
Abstract
Background: In German medical curricula, the preclinical phase is often predominantly theoretical and only weakly connected to clinical practice. Patient contact is rare, which may limit the early development of illness scripts. Consequently, students may not fully appreciate the relationships between foundational biological knowledge, disease pathophysiology, diagnosis and treatment. In this study, we implemented clinical impulse lectures within first-semester biology classes and evaluated their association with knowledge, learning strategies and perceived preparedness for clinical practice.
Material and methods: First-semester medical students received the regular biology curriculum enriched with up to six clinical impulse lectures, including one session with patient contact. Data were collected using pre-intervention (n = 227) and post-intervention (n = 105) questionnaires assessing self-perceived biological and clinical knowledge. We also assessed learning motivation and strategy as well as students'' perceptions of the connection between theory and clinical practice. A 35-item multiple-choice question (MCQ) test was administered to objectively assess knowledge (n = 71). Each clinical impulse was additionally evaluated using a short questionnaire.
Results: Students reported greater perceived preparedness regarding their biological knowledge after completing the biology course. Mean self-assessed biology knowledge improved from 2.9 to 2.3 (p < 0.001; 1 = best grade), and self-assessed clinical impulse-related knowledge improved from 3.3 to 2.5 (p < 0.001; 1 = best grade). The clinical impulses were perceived as highlighting the relevance of scientific foundations to clinical practice and as motivating integrated learning. Students who had attended more clinical impulses more frequently agreed with these statements. More than 80% supported the concept of vertical integration. In the objective MCQ assessment, students with greater exposure to clinical impulses achieved higher scores on biology questions; the difference in clinical impulse-related MCQ scores was not statistically significant.
Conclusion: Early clinical impulses were well accepted by first-semester medical students. Greater exposure was associated with stronger motivation and higher biology MCQ scores, whereas the difference in clinical impulse-related MCQ performance was not statistically significant. Given the unequal exposure groups and concurrent standard biology curriculum, these findings should be interpreted as preliminary evidence of an association rather than proof of a causal effect.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12909-026-10716-7.
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BibTeX
@article{steiner2026vertical,
title = {{Vertical integration of clinical knowledge in preclinical medical education: assessing the impact on the first-year biology curriculum in a German medical school}},
author = {Robert-Patrick Steiner and Jean-Paul Bereuter and Maximilian Vogt and Florian Bruns and Andrea Rosner and Elisabeth Dinter and Doreen William and Jeannine Schübel and Martin Bortz and Susanne Kämmerer and Marjo Wijnen-Meijer and Lydia Günther},
journal = {BMC Medical Education},
year = {2026},
month = nov,
doi = {10.1186/s12909-026-10716-7},
url = {https://doi.org/10.1186/s12909-026-10716-7},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Vertical integration of clinical knowledge in preclinical medical education: assessing the impact on the first-year biology curriculum in a German medical school
AU - Robert-Patrick Steiner
AU - Jean-Paul Bereuter
AU - Maximilian Vogt
AU - Florian Bruns
AU - Andrea Rosner
AU - Elisabeth Dinter
AU - Doreen William
AU - Jeannine Schübel
AU - Martin Bortz
AU - Susanne Kämmerer
AU - Marjo Wijnen-Meijer
AU - Lydia Günther
PY - 2026
DA - 2026/11/03
JO - BMC Medical Education
DO - 10.1186/s12909-026-10716-7
UR - https://doi.org/10.1186/s12909-026-10716-7
AB - Background: In German medical curricula, the preclinical phase is often predominantly theoretical and only weakly connected to clinical practice. Patient contact is rare, which may limit the early development of illness scripts. Consequently, students may not fully appreciate the relationships between foundational biological knowledge, disease pathophysiology, diagnosis and treatment. In this study, we implemented clinical impulse lectures within first-semester biology classes and evaluated their association with knowledge, learning strategies and perceived preparedness for clinical practice. Material and methods: First-semester medical students received the regular biology curriculum enriched with up to six clinical impulse lectures, including one session with patient contact. Data were collected using pre-intervention (n = 227) and post-intervention (n = 105) questionnaires assessing self-perceived biological and clinical knowledge. We also assessed learning motivation and strategy as well as students'' perceptions of the connection between theory and clinical practice. A 35-item multiple-choice question (MCQ) test was administered to objectively assess knowledge (n = 71). Each clinical impulse was additionally evaluated using a short questionnaire. Results: Students reported greater perceived preparedness regarding their biological knowledge after completing the biology course. Mean self-assessed biology knowledge improved from 2.9 to 2.3 (p < 0.001; 1 = best grade), and self-assessed clinical impulse-related knowledge improved from 3.3 to 2.5 (p < 0.001; 1 = best grade). The clinical impulses were perceived as highlighting the relevance of scientific foundations to clinical practice and as motivating integrated learning. Students who had attended more clinical impulses more frequently agreed with these statements. More than 80% supported the concept of vertical integration. In the objective MCQ assessment, students with greater exposure to clinical impulses achieved higher scores on biology questions; the difference in clinical impulse-related MCQ scores was not statistically significant. Conclusion: Early clinical impulses were well accepted by first-semester medical students. Greater exposure was associated with stronger motivation and higher biology MCQ scores, whereas the difference in clinical impulse-related MCQ performance was not statistically significant. Given the unequal exposure groups and concurrent standard biology curriculum, these findings should be interpreted as preliminary evidence of an association rather than proof of a causal effect. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12909-026-10716-7.
SN - 1472-6920
ER -