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Abstract
Background: Beside acquiring knowledge, medical students should also develop the ability to apply and reflect on it, requiring higher-order cognitive processing. Ideally, students should have reached higher-order cognitive processing when they enter the clinical program. Whether this is the case, is unknown. We investigated students’ cognitive processing, and awareness of their knowledge during medical school.Methods: Data were gathered from 347 first-year preclinical and 196 first-year clinical students concerning the 2008 and 2011 Dutch progress tests. Questions were classified based upon Bloom’s taxonomy: “simple questions” requiring lower and “vignette questions” requiring higher-order cognitive processing. Subsequently, we compared students’ performance and awareness of their knowledge in 2008 to that in 2011 for each question type.Results: Students’ performance on each type of question increased as students progressed. Preclinical and first-year clinical students performed better on simple questions than on vignette questions. Third-year clinical students performed better on vignette questions than on simple questions. The accuracy of students’ judgment of knowledge decreased over time.Conclusions: The progress test is a useful tool to assess students’ cognitive processing and awareness of their knowledge. At the end of medical school, students achieved higher-order cognitive processing but their awareness of their knowledge had decreased.
Highlights
Students’ ability to apply acquired knowledge has been a research topic in medical education for many years (Boshuizen & Schmidt 1992; Eva 2005; Norman 2005)
An increase in knowledge does not necessarily imply that students are able to use the acquired knowledge. It may be achieved through reproduction of factual knowledge, whereas knowledge application requires a deep understanding of factual knowledge
A correct answer is coupled with a reward, an incorrect answer with a penalty and using a question mark ends without reward or penalty
Summary
Students’ ability to apply acquired knowledge has been a research topic in medical education for many years (Boshuizen & Schmidt 1992; Eva 2005; Norman 2005). An increase in knowledge does not necessarily imply that students are able to use the acquired knowledge. It may be achieved through reproduction of factual knowledge, whereas knowledge application requires a deep understanding of factual knowledge. Medical students should develop the ability to apply and reflect on it, requiring higher-order cognitive processing. Students should have reached higher-order cognitive processing when they enter the clinical program. Results: Students’ performance on each type of question increased as students progressed. Preclinical and first-year clinical students performed better on simple questions than on vignette questions. At the end of medical school, students achieved higher-order cognitive processing but their awareness of their knowledge had decreased
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