Purpose: Medical education involves the acquisition of knowledge, skills, and reasoning abilities. A crucial aspect of education is the formation of a rich knowledge base around which specific abilities might cohere. Previous research has indicated the importance of background knowledge on diagnosis (Woods, Brooks, & Norman, 2005). We explored the idea that other foundational knowledge---knowledge outside the realm of biomedical knowledge---can facilitate in the learning and retention of a specific exam technique by providing a causal knowledge structure.
Method: We created two sets of training materials that described several respiratory conditions, the technique for conducting a percussive chest exam, as well as several outcomes and diagnoses. One set of materials (No Foundational Knowledge, or NFK) contained information that was relevant to the chest exam and supporting biomedical information. The other set (Foundational Knowledge, or FK) included the same information and also included a tutorial about the propagation of sound through solids and liquids. This additional information was couched in introductory physics terms and could be helpful in understanding the results of a chest exam by providing a causal explanation for the result of the test. Both sets of training materials were approximately equally in length (5 pages) and were a mix of text and figures. Forty undergraduates were randomly assigned to either the NFK or the FK group. Subjects first studied the training materials (about 30 minutes) and were then tested immediately following the study session. Test items included 10 control items, not related the chest exam, and 15 critical items that were related to the exam. Subjects were tested again one week later with the same items (though surface details were changed).
Result: Although subjects performed equivalently on the control items (all around 75%; an ANOVA found no significant effects), subjects in the FK group performed better on the critical items than did subjects in the NFK group. This effect was present at the first test (74% to 65% for the FK and the NFK groups) as well as in the test one week later (62% and 52%).
Conclusion: These results suggest that foundational knowledge can assist in the learning and retention of specific training material. It is likely that reasoning and decision making abilities could be affected by improved access to foundational knowledge.
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