Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Exploring lecturers’ views of first-year health science students’ misconceptions in biomedical domains


Research has indicated that misconceptions hamper the process of knowledge construction. Misconceptions are defined as persistent ideas not supported by current scientific views. Few studies have explored how misconceptions develop when first year health students conceptually move between anatomy and physiology to construct coherent knowledge about the human body. This explorative study analysed lecturers’ perceptions of first-year health science students’ misconceptions in anatomy and physiology to gain a deeper understanding of how and why misconceptions could potentially arise, by attempting to link sources of misconceptions with four schools of thought, namely theories on concept formation, complexity, constructivism and conceptual change. This was a qualitative study where ten lecturers involved in teaching anatomy and physiology in the health science curricula at the University of Cape Town were interviewed to explore perceptions of students’ misconceptions. Analytical induction was used to uncover categories within the interview data by using a coding system. A deeper analysis was done to identify emerging themes that begins to explore a theoretical understanding of why and how misconceptions arise. Nine sources of misconceptions were identified, including misconceptions related to language, perception, three dimensional thinking, causal reasoning, curricula design, learning styles and moving between macro and micro levels. The sources of misconceptions were then grouped together to assist educators with finding educational interventions to overcome potential misconceptions. This explorative study is an attempt in theory building to understand what is at the core of biomedical misconceptions. Misconceptions identified in this study hold implications for educators as not all students have the required building blocks and cognitive skills to successfully navigate their way through biomedical courses. Theoretical insight into the sources of misconceptions can assist educators in addressing potential hampering factors in the construction of coherent scientific knowledge.

This is a preview of subscription content, log in to check access.


  1. 1.

    The education system in South Africa has been an area of great concern. Numerous researchers have observed and commented on the damaging role of apartheid on tertiary education in South Africa (Burch et al. 2006; Boughey 2007) Researchers all agree that this system was responsible for deliberately creating under-resourced schools for Black students, which resulted in an imbalanced and fragmented education system in South Africa. Curriculum 2005 and an outcome—based model (OBE) model (Botha 2002) was adopted post-apartheid, to address these inequalities, but this model has also proven to be problematic, as many schools still do not have the resources to successfully implement this system.


  1. Ahopelto, I., Mikkilä-Erdmann, M., Olkinuora, E., & Kääpä, P. (2011). A follow-up study of medical students’ biomedical understanding and clinical reasoning concerning the cardiovascular system. Advances in Health Sciences Education: Theory and Practice, 16(5), 655–668.

  2. Ausubel, D. P., Novak, J. D., & Hanesian, H. (1968). (Eds). Educational psychology: A cognitive view. New York: Holt, Rinehart and Winston.

  3. Bergman, E. M., Prince, K. J. A., Drukker, J., van der Vleuten, C. P. M., & Scherpbier, A. J. (2008). How much anatomy is enough? Anatomical Sciences Education, 1(4), 184–188.

  4. Botha, R. J. (2002). Outcomes-based education and educational reform in South Africa. International Journal of Leadership in Education, 1(5), 361–371.

  5. Boughey, C. (2007). Educational development in South Africa. From social reproduction to capitalist expansion? Higher Education Policy, 20(1), 5–11.

  6. Boyatzis, R. (1998). Transforming qualitative information: Thematic and code development. Thousand Oaks, CA: Sage Publications.

  7. Bradley, E. H., Curry, L. A., & Devers, K. J. (2007). Qualitative data analysis for health services research: Developing taxonomy, themes, and theory. Health Services Research, 2007(42), 1758–1772.

  8. Burch, V. C., Sikakana, C. N. T., Yeld, N., Seggie, J. L., & Schmidt, H. G. (2006). Performance of academically at-risk medical students in a problem-based learning programme: A preliminary report. Advances in Health Science Education, 12(3), 345–358.

  9. Carey, S., & Spelke, E. S. (1994). Domain-specific knowledge and conceptual change. In L. Hirschfeld & S. Gelman (Eds.), Mapping the mind: Domain specificity in cognition and culture (pp. 169–200). Cambridge: Cambridge University Press.

  10. Carey, S., & Spelke, E. (1996). Science and core knowledge. Philosophy of Science, 63, 515–533.

  11. Chi, M. T. (2005). Commonsense conceptions of emergent processes: Why some misconceptions are robust. The Journal of the Learning Sciences, 14(2), 161–199.

  12. Chi, M. T. H. (2008). Three types of conceptual change: Belief revision, mental model transformation, and categorical shift. In S. Vosniadou (Ed.), International handbook of research on conceptual change (pp. 61–82). New York: Routledge.

  13. Cliff, W. H. (2006). Case study analysis and the remediation of misconceptions about respiratory physiology. Advances in Physiology Education, 30(1–4), 215–223.

  14. Creswell, J. W. (2007). Qualitative inquiry and research design: Choosing among five approaches. Thousand Oakes: Sage Publications.

  15. Dawson-Saunders, B., Feltovich, P. J., Coulson, R. L., & Steward, D. E. (1990). A survey of medical school teachers to identify basic biomedical concepts medical students should understand. Academic Medicine: Journal of the Association of American Medical Colleges, 65(7), 448.

  16. Denzin, N. K., & Lincoln, Y. S. (Eds.). (2011). The SAGE handbook of qualitative research. Thousand Oakes: Sage.

  17. Fyrenius, A., Silen, C., & Wirell, S. (2007). Students’ conceptions of underlying principles in medical physiology: An interview study of medical students’ understanding in a PBL curriculum. Advances in Physiology Education, 31(4), 364–369.

  18. Hand, B., Hohenshell, L., & Prain, V. (2004). Exploring students’ responses to conceptual questions when engaged with planned writing experiences: A study with year 10 science students. Journal of Research in Science Teaching, 41(2), 186–210.

  19. Lazarowitz, R., & Lieb, C. (2006). Formative assessment pre-test to identify college students’ prior knowledge, misconceptions and learning difficulties in biology. International Journal of Science and Mathematics Education, 4(4), 741–762.

  20. Lewis, J., & Wood-Robinson, C. (2000). Genes, chromosomes, cell division and inheritance—Do students see any relationship? International Journal of Science Education, 22(2), 177–195.

  21. Marbach-Ad, G., & Stavy, R. (2000). Students’ cellular and molecular explanations of genetic phenomena. Journal of Biological Education, 34(4), 200–205.

  22. Medin, D. L., & Smith, E. E. (1984). Concepts and concept formation. Annual Review of Psychology, 35(1), 113–138.

  23. Michael, J. (2002). Misconceptions—What students think they know. Advances in Physiology Education, 26(1), 5–6.

  24. Michael, J. (2007). What makes physiology hard for students to learn? Results of a faculty survey. Advances in Physiology Education, 31(1), 34–40.

  25. Michael, J., Modell, H., McFarland, J., & Cliff, W. (2009). The “core principles” of physiology: What should students understand? Advances in Physiology Education, 33, 10–16.

  26. Michael, J. A., Richardson, D., Rovick, A., Modell, H., Bruce, D., Horwitz, B., et al. (1999). Undergraduate students’ misconceptions about respiratory physiology. Advances in Physiology Education, 22(1), 127–135.

  27. Michael, J. A., Wenderoth, M. P., Modell, H. I., Cliff, W., Horwitz, B., McHale, P., et al. (2002). Undergraduates’ understanding of cardiovascular phenomena. Advances in Physiology Education, 26(2), 72–84.

  28. Modell, H. I. (1997). How can we help students learn respiratory physiology? Advances in Physiology Education, 18(1), 68–74.

  29. Modell, H. I. (2000). How to help students understand physiology? Emphasize general models. Advances in Physiology Education, 23(1), 101.

  30. Modell, H. I. (2004). Evolution of an educator: Lessons learned and challenges ahead. Advances in Physiology Education, 28(3), 88–94.

  31. Older, J. (2004). Anatomy: A must for teaching the next generation. The Surgeon, 2(2), 79–90.

  32. Patel, V. L., Glaser, R., & Arocha, J. F. (2000). Cognition and expertise: Acquisition of medical competence. Clinical and Investigative Medicine, 23(4), 256–260.

  33. Patel, V. L., Kaufman, D. R., & Magder, S. (1991). Causal explanation of complex physiological concepts by medical students. International journal of science education, 13(2), 171–185.

  34. Patton, M. Q. (2002). (Eds.) Qualitative research and evaluation methods. Thousand Oakes: Sage.

  35. Piaget, J. (1980). Adaptation and intelligence: Organic selection and phenocopy. Chicago: University of Chicago Press.

  36. Posner, G. J., Strike, K. A., Hewson, P. W., & Gertzog, W. A. (1982). Accommodation of a scientific conception: Toward a theory of conceptual change. Science Education, 66(2), 211–227.

  37. Quinn, F., Pegg, J., & Panizzon, D. (2009). First-year biology students’ understandings of meiosis: An investigation using a structural theoretical framework. International Journal of Science Education, 31(10), 1279–1305.

  38. Richmond, G., Merritt, B., Urban-Lurain, M., & Parker, J. (2010). The development of a conceptual framework and tools to assess undergraduates’ principled use of models in cellular biology. CBE-Life Sciences Education, 9(4), 441–452.

  39. Riemeier, T., & Gropengießer, H. (2008). On the roots of difficulties in learning about cell division: Process-based analysis of students’ conceptual development in teaching experiments. International Journal of Science Education, 30(7), 923–939.

  40. Rowbottom, D. P. (2007). Demystifying threshold concepts. Journal of Philosophy of Education, 41(2), 263–270.

  41. Ryan, G. W., & Bernard, H. R. (2003). Techniques to identify themes. Field Methods, 15(1), 85–109.

  42. Schmidt, H. G., & Boshuizen, H. P. A. (1993). On acquiring expertise in medicine. Educational Psychology Review, 5(3), 205–221.

  43. Silverman, D. (2000). Doing qualitative research: A practical handbook. Thousand Oaks, CA: Sage.

  44. Sweller, J. (2006). How the human cognitive system deals with complexity. In J. Elen & R. E. Clark (Eds.), Handling complexity in learning environments: Research and theory and research (pp. 13–265). Oxford: Elsevier Science Limited.

  45. Treagust, D. F., & Duit, R. (2008). Conceptual change: A discussion of theoretical, methodological and practical challenges for science education. Cultural Studies of Science Education, 3(2), 297–328.

  46. Tufts, M. A., & Higgins-Opitz, S. B. (2009). What makes the learning of physiology in a PBL medical curriculum challenging? Student perceptions. Advances in physiology education, 33(3), 187–195.

  47. Vosniadou, S. (2007). The cognitive-situative divide and the problem of conceptual change. Educational Psychologist, 42(1), 55–66.

  48. Vosniadou, S. (2008). (Eds.) International handbook of research on conceptual change. New York: Routledge.

Download references


The authors are grateful to the lecturers who dedicated their time to participate in the study, and to Dr. Viki Janse Van Rensburg and Ms. Melanie Alperstein of the Education Unit at the Faculty of Health Sciences, University of Cape Town who assisted with the data analysis process.

Author information

Correspondence to Elmi Badenhorst.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Badenhorst, E., Mamede, S., Hartman, N. et al. Exploring lecturers’ views of first-year health science students’ misconceptions in biomedical domains. Adv in Health Sci Educ 20, 403–420 (2015). https://doi.org/10.1007/s10459-014-9535-3

Download citation


  • Conceptual change
  • Concept formation
  • Complexity
  • Health science students
  • Integration of physiology and anatomy knowledge
  • Knowledge construction
  • Misconceptions