Enhancing Basic Sciences Teaching: The Need for More Theory and Focus on Transfer to Clinical Reasoning
thesisposted on 18.10.2016, 00:00 by Jean-Marie Castillo
“Transfer” is the application of a previously learned concept to solve a new problem in another context. Transfer is a critical, but difficult, dimension of basic sciences education. Limited understanding of effective interventions in health professions education (HPE) can hamper teachers and researchers from enhancing transfer of learning. This study identifies interventions designed to develop basic sciences knowledge in HPE and describes their contexts, approaches and outcomes. This study also examines evidence of interventions fostering our understanding of basic sciences education, and particularly studies documenting transfer of basic sciences knowledge to foster clinical reasoning. An integrative literature review was conducted to identify articles related to basic sciences teaching at the “undergraduate level” in HPE, published between 1980 and 2015, including learning outcomes. Articles were selected and summarized based on their context, approaches, and outcomes. Articles reporting interventions that enhance understanding of basic sciences education were analyzed. Out of 9,803 articles initially identified, 78 were selected for further review; ninety-eight percent (98%) focused on how to introduce the basic sciences learning concept and the remaining 2% focused on the practice of multiple clinical problems to teach the learning concept. The methods of transfer were explored in 35% of the papers. Eighty-five percent (85%) were practice-based research, 15% were use-inspired basic research (i.e., goal of improving practice and understanding of the phenomenon studied). Teaching interventions that were successful to enhance the transfer of basic sciences learning concepts to clinical reasoning developed deep conceptual structures of the learning concepts. The development of such deep conceptual structures was achieved in these studies through the presentation of causal mechanisms of clinical features or analogies, and the practice of multiple problems in multiple contexts. Factual recall memory tests did not detect differences in transfer. Evidence is still lacking regarding transfer of basic sciences knowledge to clinical reasoning in HPE. A theoretically-grounded focus on transfer and its understanding is likely to support the development of basic sciences education.