The explanation of clinical concepts by expert physicians, clerks, and advanced students

van de Wiel, MWJ Boshuizen, HPA Schmidt, HG Schaper, NC

Mwj. Van De Wiel et al., The explanation of clinical concepts by expert physicians, clerks, and advanced students, TEACH L MED, 11(3), 1999, pp. 153-163

27

INGLESE

Article

General & Internal Medicine

TEACHING AND LEARNING IN MEDICINE

1040-1334 → ACNP

11

3

1999

153 - 163

ISI

1040-1334(1999)11:3<153:TEOCCB>2.0.ZU;2-Y

Background: Research has shown that medical expertise is the result of chan ges in the nature and organization of knowledge. Purpose: This study investigated the content and organization of medical kn owledge in participants with different clinical experience. Methods: Advanced students, clerks, and internists were required to explain 20 current clinical concepts in approximately 2 min per concept. The expla nations were analyzed on elaborateness, quality, and fluency with which the y were provided. Results: The more experienced participants generally provided more elaborat e, qualitatively better, and more fluent explanations. For some concepts, t he explanations of students and clerks equaled those of experts in quality, but these were less fluently and coherently formulated. Conclusions: Practical experience is an important mediator for meaningful i ntegration of biomedical and clinical knowledge. Pathophysiological knowled ge relating causes and consequences of disease does not decay with experien ce, but rather forms a coherent knowledge structure that can be easily acce ssed. This supports the hypothesis of knowledge encapsulation.