Integrative cases for preclinical medical students: Connecting the dots from the basic and clinical sciences to public health

Leaders are seeking to integrate public health approaches with clinical care to improve population health outcomes. The Institute of Medicine has called for the U.S. public health system to move from a government-centered approach to one involving broad partnerships, including health care and the community. Medical education must respond with curriculum to prepare future physicians for this transformed public health system. In 2007, the University of Wisconsin School of Medicine and Public Health created “Integrative Cases” to provide first and second-year medical students with more awareness, knowledge, and skills in integrating public health into clinical practice. Students explore public health problems through active, experiential activities and small group discussions. Clinicians lead the cases, demonstrating the relevance of public health to the basic and clinical sciences; community members participate, demonstrating the importance of public health approaches and collaboration. Student evaluations indicate that Integrative Cases add to student understanding of public health issues and their relevance and application to patient care. Students have increased their ability to: (1) Identify connections across basic science, clinical medicine and public health; (2) Differentiate population and individual approaches to health; (3) Participate in experiences that introduce a more expansive view of medicine and public health; (4) Explore questions that promote interest and inquiry towards lifelong learning; (5) Describe the impacts of multiple systems on health; (6) Analyze patient perspectives in the context of clinical and public health approaches; and (7) Demonstrate strategies that integrate a public health perspective to improve the health of individuals and communities.