Phenomenographic study of basic science understanding-senior medical students' conceptions of fatigue

Niklas Wilhelmsson; Lars Owe Dahlgren; Håkan Hult; Staffan Wirell; Torbjörn Ledin; Anna Josephson

doi:10.4103/1357-6283.125990

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ORIGINAL RESEARCH ARTICLE

Year : 2013 | Volume : 26 | Issue : 3 | Page : 156-163

Phenomenographic study of basic science understanding-senior medical students' conceptions of fatigue

Niklas Wilhelmsson¹, Lars Owe Dahlgren², Håkan Hult², Staffan Wirell³, Torbjörn Ledin⁴, Anna Josephson⁵
¹ Department of Learning, Centre for Medical Education, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
² Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
³ Unit of Radiology, Department of Medicine and Care, Faculty of Health Sciences, Linköping University, Linköping, Sweden
⁴ Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden and Department of Otorhinolaryngology, County Council of Östergötland, Linköping, Sweden
⁵ Department of Neuroscience, Karolinska Institutet, Sweden

Correspondence Address:
Niklas Wilhelmsson
Centre for Medical Education, Department of Learning, Informatics, Management and Ethics, Berzelius väg 3, Karolinska Institutet, 171 77 Stockholm
Sweden

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/1357-6283.125990

Introduction: Helping students learn to apply their newly learned basic science knowledge to clinical situations is a long-standing challenge for medical educators. This study aims to describe how medical students' knowledge of the basic sciences is construed toward the end of their medical curriculum, focusing on how senior medical students explain the physiology of a given scenario. Methods A group of final-year medical students from two universities was investigated. Interviews were performed and phenomenographic analysis was used to interpret students' understanding of the physiology underlying the onset of fatigue in an individual on an exercise bicycle. Results: Three categories of description depict the qualitatively different ways the students conceptualized fatigue. A first category depicts well integrated physiological and bio-chemical knowledge characterized by equilibrium and causality. The second category contains conceptions of finite amount of substrate and juxtaposition of physiological concepts that are not fully integrated. The third category exhibits a fragmented understanding of disparate sections of knowledge without integration of basic science and clinical knowledge. Discussion: Distinctive conceptions of fatigue based with varying completeness of students' understanding characterized the three identified categories. The students' conceptions of fatigue were based on varying understanding of how organ systems relate and of the thresholds that determine physiological processes. Medical instruction should focus on making governing steps in biological processes clear and providing opportunity for causal explanations of clinical scenarios containing bio-chemical as well as clinical knowledge. This augments earlier findings by adding descriptions in terms of the subject matter studied about how basic science is applied by students in clinical settings.

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