It takes a Village: Team Teaching in an Integrated and Spiraled Medical Sciences Curriculum.

Medical education continues to evolve with more schools adopting integrated, systems-based curricula with reduced basic sciences contact hours in favor of more clinical content. While the reduced basic sciences time may jeopardize student competency, there are opportunities to impactfully integrate and teach basic sciences in an evidence-based way to promote long-term retention and higher-ordered usage of the learned knowledge. This involves a multidisciplinary team approach to curricular design and collaborative teaching. Foundational Principles course at the University of Colorado School of Medicine was intentionally designed as an integrated, spiral curriculum to expose the new students to the ten basic sciences contents at the introductory level, presented within the clinical framework. Each week of the course starts with a common chief concern (muscle weakness for example), and the classes during the week present various subjects such as anatomy, physiology, histopathology, and embryology of neuromusculature that students will need to learn to support patients. Therefore, all the classes during the week require subject experts to work as a team to organize and sequence the classes to support the most effective and impactful learning in students. At the end of each week, students complete a low-stakes assessment to identify knowledge gaps. The highly integrated nature of each week therefore also requires subject experts to work as a team to construct valid and reliable integrated assessments. The positive aspects of the educators' teamwork in the integrated spiral curriculum include: 1) identification and consolidation of redundant content coverage or discrepancies; 2) team teaching opportunities leading to a dynamic and interactive learning experience for students to understand the connections among multiple disciplines; 3) opportunities to role-model for students how professional colleagues from different fields handoff, communicate and collaborate; 4) intentional placement of fundamental concepts taught by different subject experts later in the course for spaced learning; 5) learning and professional development of faculty from interdisciplinary collaboration. Some of the major challenges with the curriculum that demands robust teamwork are scheduling meetings that work for all team members, buy-in from all team members, and negotiating contact hours for various subjects. Several collaborative software and resources such as virtual meetings, and a platform for sharing documents and instant communications are critical in orchestrating such a curriculum. Students' performance in weekly assessments and the comprehensive end-of-course exam indicate excellent learning outcomes. Students' evaluation of the course suggests that the team-based approach to the integrated spiral curricular design and team teaching were well received, however, opportunities to enhance the course were also identified such as better curation and clear communication of the depth of multiple disciplines students need to learn each week. Deliberately signposting how each disciplines intersect, especially if the related subjects are not team-taught, is another area to enhance to support student learning. A multidisciplinary team approach to curricular design and teaching presents opportunities to effectively teach and reintegrate basic sciences into the medical curricula.