Using a conceptual framework during learning attenuates the loss of expert-type knowledge structure.

Kerry Novak,Henry Mandin,Elizabeth Wilcox,Kevin Mclaughlin

doi:10.1186/1472-6920-6-37

Abstract

BackgroundDuring evolution from novice to expert, knowledge structure develops into an abridged network organized around pathophysiological concepts. The objectives of this study were to examine the change in knowledge structure in medical students in one year and to investigate the association between the use of a conceptual framework (diagnostic scheme) and long-term knowledge structure.MethodsMedical students' knowledge structure of metabolic alkalosis was studied after instruction and one year later using concept-sorting. Knowledge structure was labeled 'expert-type' if students shared ≥ 2 concepts with experts and 'novice-type' if they shared < 2 concepts. Conditional logistic regression was used to study the association between short-term knowledge structure, the use of a diagnostic scheme and long-term knowledge structure.ResultsThirty-four medical students completed the concept-sorting task on both occasions. Twenty-four used a diagnostic scheme for metabolic alkalosis. Short-term knowledge structure was not a correlate of long-term knowledge structure, whereas use of a diagnostic scheme was associated with increased odds of expert-type long-term knowledge structure (odds ratio 12.6 [1.4, 116.0], p = 0.02). There was an interaction between short-term knowledge structure and the use of a diagnostic scheme. In the group who did not use a diagnostic scheme the number of students changing from expert-type to novice-type was greater than vice versa (p = 0.046). There was no significant change in the group that used the diagnostic scheme (p = 0.6).ConclusionThe use of a diagnostic scheme by students may attenuate the loss of expert-type knowledge structure.

Highlights

During evolution from novice to expert, knowledge structure develops into an abridged network organized around pathophysiological concepts
The use of a diagnostic scheme by students may attenuate the loss of expert-type knowledge structure
Seventy two percent of students used the diagnostic scheme for metabolic alkalosis

Summary

Introduction

During evolution from novice to expert, knowledge structure develops into an abridged network organized around pathophysiological concepts. Medical knowledge is thought to be stored in a network structure and connections between items made on the basis of both pathophysiological and clinical associations [2,3]. During the evolution from novice to expert a large amount of new information about diseases is incorporated into the knowledge network and the structure is thought to evolve into an abridged network within which knowledge items are encapsulated into higher order concepts [4]. An important assumption [and criticism] of CMA is that the map generated represents the 'true' knowledge structure of the subject rather than merely a creation of the research tool; a hypothesis that is difficult to prove. The observation, that the map generated by CMA correlates with performance provides some support for this assumption upon which CMA is based [7,8]

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