The application of basic science concepts to clinical problem-solving

Abstract

This study looks at the relationship between anatomical concepts held by medical students and their clinical application, and develops a testable model of how students use basic science concepts for clinical problem-solving. According to the model, the essential prerequisites to solve a clinical problem using basic science information include the appropriate basic science knowledge, the ability to collect and interpret clinical information, with the key concept being the link that must then be made between clinical data and basic science. A detailed analysis of the individual components of the model should help to clarify and resolve some of the debate about the nature and balance of basic science and clinical education. A neurological diagnostic problem was used to test the assumptions of the model in a group of medical students who had minimal clinical experiences. There was no demonstrable relationship between anatomical knowledge as assessed by conventional tests and the diagnosis. There was a powerful relationship between measures of organization of knowledge and diagnosis, suggesting that the organization and development of concepts is the key to correct diagnosis. The findings have significant implications for assessment purposes and suggest that standard methods as generally practised may not measure the appropriate conceptual development and are not congruent with curricular objectives. Through the examination of its different learning outcome measures, the model may also be used to provide a profile of individual students or classes, which should help teachers and students deal with difficulties that may be experienced in learning to link clinical and basic science concepts.

Cognitive factors in student nurses’ clinical problem solving

“…Previous research by Cholowski and Chan (1992) found a strong relationship between student nurses’ performance on a clinical problem‐solving task and the quality of their diagnostic reasoning. Similar findings have been obtained from studies with medical students (Balla et al. 1990).…”

Minimal Impact of Organic Chemistry Prerequisite on Student Performance in Introductory Biochemistry

“…For example, although completion of the freshman writing prerequisite improved student performance in a business communication class, no positive association was observed for the computer literacy prerequisite (Marcal and Roberts, 2000). Similarly, Balla et al (1990) found that basic anatomy knowledge did not positively correlate with the ability of medical students to perform effective clinical diagnoses. Furthermore, nursing students' grades in a research course did not strongly correlate with their grades in the prerequisite statistics course (Grace and D'Aoust, 2006).…”

An evaluation of the use of continuous assessment in the teaching of physiology

“…The capacity to apply basic sciences knowledge in appropriate clinical situations is a major objective of teaching the basic sciences. However, recent studies indicate that a large number of students are unable to effectively use basic sciences theory in diagnostic problem-solving (Whelan 1988;Ramsden, Whelan and Cooper 1989;Balla, Biggs, Gibson and Chang 1990;Patel, Evans and Kaufman 1990).…”

“…Thus, the organization and development of concepts would appear to be the key to good clinical reasoning and diagnosis (Balla, Biggs, Gibson and Chang 1990), in which the goal is to explain the underlying causal mechanism(s) of the clinical signs and symptoms, as a prerequisite step to making effective treatment and clinical management decisions.…”