Advances in Health Sciences Education

, Volume 17, Issue 4, pp 547–555 | Cite as

Expanding the basic science debate: the role of physics knowledge in interpreting clinical findings

  • Mark Goldszmidt
  • John Paul Minda
  • Sarah L. Devantier
  • Aimee L. Skye
  • Nicole N. Woods


Current research suggests a role for biomedical knowledge in learning and retaining concepts related to medical diagnosis. However, learning may be influenced by other, non-biomedical knowledge. We explored this idea using an experimental design and examined the effects of causal knowledge on the learning, retention, and interpretation of medical information. Participants studied a handout about several respiratory disorders and how to interpret respiratory exam findings. The control group received the information in standard “textbook” format and the experimental group was presented with the same information as well as a causal explanation about how sound travels through lungs in both the normal and disease states. Comprehension and memory of the information was evaluated with a multiple-choice exam. Several questions that were not related to the causal knowledge served as control items. Questions related to the interpretation of physical exam findings served as the critical test items. The experimental group outperformed the control group on the critical test items, and our study shows that a causal explanation can improve a student’s memory for interpreting clinical details. We suggest an expansion of which basic sciences are considered fundamental to medical education.


Causal knowledge Learning Retention Basic science 



This research was supported by a Research Developments Initiative Grant from the Social Science and Humanities Research Council of Canada to JPM.


  1. Bickley, L., Szilagyi, P. G., & Bates, B. (2007). Bates’ guide to physical examination and history taking. Philiadelphia, PA: Lippincott, Williams & Wilkins.Google Scholar
  2. Finnerty, E. P., Chauvin, S., Bonaminio, G., Andrews, M., Carroll, R. G., & Pangaro, L. N. (2010). Flexner revisited: The role and value of the basic sciences in medical education. Academic Medicine, 85, 349–355.CrossRefGoogle Scholar
  3. Irby, D. M., Cooke, M., & O’Brien, B. C. (2010). Calls for reform of medical education by the carnegie foundation for the advancement of teaching: 1910 and 2010. Academic Medicine, 85, 220–227.CrossRefGoogle Scholar
  4. Keil, F. C. (2006). Explanation and understanding. Annual Review of Psychology, 57, 227–254.CrossRefGoogle Scholar
  5. Murphy, G. L., & Medin, D. L. (1985). The role of theories in conceptual coherence. Psychological Review, 92, 289–316.CrossRefGoogle Scholar
  6. Norman, G. (2005). Research in clinical reasoning: Past history and current trends. Medical Education, 39, 418–427.CrossRefGoogle Scholar
  7. Norman, G. R., Trott, A. L., Brooks, L. R., & Smith, E. K. M. (1994). Cognitive differences in clinical reasoning related to postgraduate training. Teaching and Learning in Medicine, 6, 114–120.CrossRefGoogle Scholar
  8. Norman, G., Eva, K., Brooks, L. R., & Hamstra, S. (2006). Expertise in medicine and surgery. In K. A. Ericsson, N. Charness, P. L. Feltovich, & R. R. Hoffman (Eds.), The Cambridge handbook of expertise and expert performance (pp. 339–353). Cambridge, UK: Cambridge University Press.CrossRefGoogle Scholar
  9. Norman, G. R., Dore, K., Krebs, J., & Neville, A. J. (2007). The power of the plural: Effect of conceptual analogies on successful transfer. Academic Medicine, 82, S16–S18.CrossRefGoogle Scholar
  10. Patel, V. L., & Groen, G. J. (1986). Knowledge-based solution strategies in medical reasoning. Cognitive Science, 10, 91–116.CrossRefGoogle Scholar
  11. Rehder, B. (2010). Causal-based classification: A review. In B. H. Ross (Ed.), The psychology of learning and motivation, vol. 52. (pp 29–116). Burlington, VT: Academic Press 52, 29–116.Google Scholar
  12. Schmidt, H. G., & Boshuizen, H. P. A. (1993). On acquiring expertise in medicine. Educational Psychology Review, 5, 205–221.CrossRefGoogle Scholar
  13. Schmidt, H. G., Norman, G. R., & Boshuizen, H. P. A. (1990). A cognitive perspective on medical expertise: Theory and implications. Academic Medicine, 65, 611–621.CrossRefGoogle Scholar
  14. The Association of Faculties of Medicine of Canada. (2009). The future of medical education in Canada (FMEC): A collective vision for MD education. Ottawa, ON: The Association of Faculties of Medicine of Canada.Google Scholar
  15. Verkoeijen, P. P. J. L., Rikers, R. M. J. P., Schmidt, H. G., Van De Wiel, M. W. J., & Kooman, J. P. (2004). Case representation by medical experts, intermediates and novices for laboratory data presented with or without a clinical context. Medical Education, 38, 617–627.CrossRefGoogle Scholar
  16. Weslby, P. D., & Earis, J. E. (2001). Some high pitched thoughts on chest examination. Postgraduate Medical Journal, 77, 617–620.CrossRefGoogle Scholar
  17. Woods, N. N., Brooks, L. R., & Norman, G. R. (2005). The value of basic science in clinical diagnosis: Creating coherence among signs and symptoms. Medical Education, 39, 107–112.CrossRefGoogle Scholar
  18. Woods, N. N., Howey, E. H. A., Brooks, L. R., & Norman, G. R. (2006). Speed kills? Speed, accuracy, encapsulations and causal understanding. Medical Education, 40, 973–979.CrossRefGoogle Scholar
  19. Woods, N., Brooks, L. R., & Norman, G. R. (2007). The role of biomedical knowledge in diagnosis of difficult clinical cases. Advances in Health Sciences Education, 12, 417–426.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  1. 1.Schulich School of Medicine and DentistryThe University of Western OntarioLondonCanada
  2. 2.Department of PsychologyThe University of Western OntarioLondonCanada
  3. 3.Department of PsychologyGrant McEwan UniversityEdmontonCanada
  4. 4.Wilson CentreUniversity of TorontoTorontoCanada

Personalised recommendations