On the origin of intermediate effects in clinical case recall

In two experiments, the effects of level of medical expertise and study time on free recall of a clinical case were assessed. In Experiment 1, a nonmonotonic relationship between level of expertise and recall was found: Subjects of intermediate levels of expertise remembered more information from the case than both experts and novices. This "intermediate effect" disappeared, however, when study time was restricted. Analysis of post hoc acquired protocols of pathophysiological knowledge active during case processing suggested that this phenomenon could be attributed to the nature of the pathophysiological knowledge mobilized to comprehend the case. In Experiment 2, this assumption was directly tested by priming relevant pathophysiological knowledge for either a short or a longer period, before enabling subjects to study the case briefly. Free-recall data confirmed and extended the results of Experiment 1. Again, an intermediate effect was found; this time, however, it was generated experimentally. The findings were interpreted in terms of qualitative differences in the nature of the knowledge structures underlying performance between novices, advanced students, and medical experts: Experts use knowledge in an encapsulated mode while comprehending a case, whereas students use elaborated knowledge

Learning Professional Knowledge: Bachelor Nursing Students’ Experiences in Learning and Knowledge Quality Outcomes in a Competence-Based Curriculum

Since decades, nursing education struggles with a persistent gap between the theoretical knowledge offered in the study program and its application in professional practice. To bridge this gap competence-based curricula were developed with instructional designs as authentic learning contexts and self-directed learning. In this project we explored final year Bachelor Nursing (BN) students’ experiences in learning in a newly developed curriculum, and their knowledge quality outcomes and the degree of agreement with knowledge requirements. An instrumental multiple case study was conducted with interviews, concept mapping and a domain knowledge list. Results show that a third of the participants had positive learning experiences and got high appraisals for their knowledge quality. Similar to the medium and low scoring participants, they developed instrumental knowledge but integrated other forms of learning into a system of meaning, which is needed to solve non-routine problems in future practice. Medium and low scoring participants did not profit from learning in authentic contexts and self-directed learning. In conclusion, developing sufficient professional knowledge in a constructivist competence-based curriculum is influenced by students’ intrinsic motivation to build a strong knowledge base, by their perception of how to learn and use professional knowledge, and their expectations of the degree of supervision and guidance by the teacher. It is recommended to evaluate the extent to which the intended curriculum is being taught

Effects of problem-based discussion on studying a subsequent text: A randomized trial among first year medical students

The Purpose of this study was to examine effects of group discussion of a medical problem on the comprehension of a subsequent problem-relevant text by first year medical students. Forty-eight first-year medical students were randomly assigned to one of two conditions: The experimental group discussed a problem of blood pressure regulation, where the control group discussed a problem of vision. Subsequently, all students studied a text on the physiology of blood pressure regulation. Finally, a free recall test was administered. Numbers of propositions accurately recalled were analyzed using analysis of variance (ANOVA). Students who discussed the blood pressure regulation problem recalled 25% more from the text than those who discussed the control problem. This difference was statistically significant. The present study represented the first truly randomized trial in the ecologically valid context of a medical curriculum. It demonstrated the positive effects of problem-based tutorial group discussion on the comprehension of text. It confirmed earlier findings from laboratory studies that problem-based learning, in addition to positive emotional and motivational long-term effects well-documented in the literature, also has positive effects on learning

Unboxing the black box of visual expertise in medicine

Visual expertise in medicine has been a subject of research since many decades. Interestingly, it has been investigated from two little related fields, namely the field that focused mainly on the visual search aspects whilst ignoring higher-level cognitive processes involved in medical expertise, and the field that mainly focused on these higher-level cognitive processes largely ignoring the relevant visual aspects. Consequently, both research lines have traditionally used different methodologies. Recently, this gap is being increasingly closed and this special issue presents methods to investigate visual expertise in medicine from both research lines, namely those investigating vision (eye tracking, pupillometry, flash preview moving window paradigm), verbalisations, brain activity, and performance measures (ROC analysis, gesture coding, expert performance approach). We discuss the benefits and drawbacks of each method and suggest directions for future research that could help to unbox the black box of visual expertise in medicine.</p

Development of university teachers’ professional vision of students’ prior knowledge during a short pedagogical training

To support university students’ learning, teaching should build on students’ prior knowledge. Therefore, teachers need skills to pay attention to students’ knowledge in teaching-learning situations. Teachers’ underlying conceptual knowledge affects the way they see and interpret situations in classrooms, which is called professional vision. This study examined university teachers’ (N = 53 from different faculties, current and future faculty) professional vision and misconceptions from the perspective of the role of prior knowledge in learning, when watching and interpreting short videos of teaching-learning situations at the start of and after a short pedagogical training. Additionally, participants’ conceptions, beliefs and approaches to teaching and learning were investigated with a questionnaire. The results show that before the training, there were differences between the teachers from different faculties, but after the training all the teachers scored better in their professional vision concerning prior knowledge. Prospective teachers’ professional vision developed even more than those of current faculty. Furthermore, more developed professional vision was related to more constructivist beliefs of learning. The results show that even short pedagogical interventions can improve teachers’ pedagogical vision. Pedagogical implications of the results are discussed.Peer reviewe