Biomedical Science Knowledge Contributes to the Development of Adaptive Expertise and Formation of a Professional Identity: An Applied Thematic Analysis of Medical Students' Essays

Abstract

Background Intensive study of the biomedical sciences remains a core component of undergraduate medical education with medical students often completing up to two years of biomedical science training prior to entering clerkships. While it is generally accepted that biomedical science knowledge is essential for clinical practice because it forms the basis of clinical reasoning and decision-making, whether medical students perceive an expanded role for their biomedical science knowledge remains to be examined. Methods We conducted an applied thematic analysis to explore how medical students in the first clerkship year perceived the relevance of biomedical science knowledge to clinical medicine during this pivotal time as they begin their transition from students to physicians. To identify previously unidentified perspectives and insights, we asked students to write brief essays in response to the prompt: How is biomedical science knowledge relevant to clinical medicine? Results Applied thematic analysis of students’ essays revealed ten codes from which four themes emerged. The analysis revealed novel perspectives previously unidentified by survey studies and focus groups. Specifically, students perceived their biomedical science knowledge as contributory to the development of adaptive expertise and professional identity formation, both viewed as essential developmental milestones for medical students. Conclusions The results of this study suggest that biomedical science knowledge contributes to medical students’ acquisition of adaptive expertise and their development of a professional identity. These findings have important implications in the setting of accelerated medical school programs in which training in the biomedical sciences are compressed or truncated. Thus, the contextual factors of the learning environment, including both explicit and tacit elements of the formal, informal, and hidden curriculum, that enable biomedical science knowledge to contribute to these developmental processes need to be identified and studied so that they are leveraged rather than lost during curricular reform.