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.