Abstract
BackgroundThe explication of relations between clinical and basic sciences can help vertical integration in medical curricula. Concept mapping might be a useful technique for this explication. Little is known about teachers’ ability regarding the articulation of integration. We examined therefore which factors affect the learning of groups of clinicians and basic scientists on different expertise levels who learn to articulate the integration of clinical and basic sciences in concept maps.MethodsAfter a pilot for fine-tuning group size and instructions, seven groups of expert clinicians and basic scientists and seven groups of residents with a similar disciplinary composition constructed concept maps about a clinical problem that fit their specializations. Draft and final concepts maps were compared on elaborateness and articulated integration by means of t-tests. Participants completed a questionnaire on motivation and their evaluation of the instructions. ANOVA’s were run to compare experts’ and residents’ views. Data from video tapes and notes were qualitatively analyzed. Finally, the three data sources were interpreted in coherence by using Pearson’s correlations and qualitative interpretation.ResultsResidents outshone experts as regards learning to articulate integration as comparison of the draft and final versions showed. Experts were more motivated and positive about the concept mapping procedure and instructions, but this did not correlate with the extent of integration fond in the concept maps. The groups differed as to communication: residents interacted from the start (asking each other for clarification), whereas overall experts only started interaction when they had to make joint decisions.ConclusionsOur results suggest that articulation of integration can be learned, but this learning is not related to participants’ motivation or their views on the instructions. Decision making and interaction, however, do relate to the articulation of integration and this suggests that teacher learning programs for designing integrated educational programmes should incorporate co-construction tasks. Expertise level turned out to be decisive for both the level of articulation of integration, the ability to improve the articulated integration and the cooperation pattern.
Highlights
The explication of relations between clinical and basic sciences can help vertical integration in medical curricula
Additional analysis comparing resident and expert concept maps revealed that only the residents were responsible for the significant improvements in articulated integration
Residents articulated integration of clinical and basic sciences to a greater extent (Vink SC, Van Tartwijk J, Bolk JH, Verloop N, Gosselink MJ: Consistent variations between concept maps constructed by expert groups and residents, submitted), they improved their articulated integration to a greater extent, as the differences between draft and final versions show
Summary
The explication of relations between clinical and basic sciences can help vertical integration in medical curricula. To develop a curriculum that addresses this so-called vertical integration requires the articulation of basic science mechanisms and their relations with clinical concepts, because designing an educational programme requires a clear view on what knowledge should be incorporated [2]. Clinical teachers, often experienced clinicians, are used to rely on illness scripts when analysing patient cases [3], using so-called chains of practice [1] Their basic science knowledge pertains to the underlying mechanisms of understanding these patient cases, but tends to remain inactivated when they analyse patient cases that to them are not complicated [4,5]. For the development of an integrated curriculum, teachers should be able to decide which clinical and basic science concepts, and which relations between them, should be incorporated in the programme in order to design assignments, choose relevant patient cases and guide student discussions. Concept mapping is recommended as a means to elicit tacit knowledge [8] and might help medical teachers to articulate relations between clinical and basic science knowledge [1,9]
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