The explanation of medical concepts by expert physicians, clerks and advanced students

Background: Research has shown that medical expertise is the result of changes in the nature and organization of knowledge. Purpose: This study investigated the content and organization of medical knowledge in participants with different clinical experience. Methods: Advanced students, clerks, and internists were required to explain 20 current clinical concepts in approximately 2 min per concept. The explanations were analyzed on elaborateness, quality, and fluency with which they were provided. Results: The more experienced participants generally provided more elaborate, qualitatively better, and more fluent explanations. For some concepts, the explanations of students and clerks equaled those of experts in quality, but these were less fluently and coherently formulated. Conclusions: Practical experience is an important mediator for meaningful integration of biomedical and clinical knowledge. Pathophysiological knowledge relating causes and consequences of disease does not decay with experience, but rather forms a coherent knowledge structure that can be easily accessed. This supports the hypothesis of knowledge encapsulation.

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