The role of encapsulated knowledge in clinical case representations of medical students and family doctors
Article first published online: 15 SEP 2004
Volume 38, Issue 10, pages 1035–1043, October 2004
How to Cite
Rikers, R. M. J. P., Loyens, S. M. M. and Schmidt, H. G. (2004), The role of encapsulated knowledge in clinical case representations of medical students and family doctors. Medical Education, 38: 1035–1043. doi: 10.1111/j.1365-2929.2004.01955.x
- Issue published online: 15 SEP 2004
- Article first published online: 15 SEP 2004
- Received 23 July 2003; editorial comments to authors 26 September 2003, 28 October 2003; accepted for publication 4 November 2003
- medical undergraduate/*methods;
- diagnostic techniques and procedures/*standards;
- clinical competence/ standards;
- medical records/ standards;
- physicians family;
Background Previous studies on the development of medical expertise, predominantly using measures of free recall and pathophysiological explanations, have shown ambiguous results concerning the relationship between expertise level and encapsulated knowledge.
Purpose To investigate differences in clinical case representations by medical students and family doctors. In particular, the role of encapsulated knowledge in clinical case representations was investigated.
Methods Year 2 (n = 15) and Year 4 (n = 15) medical students and family doctors (n = 15) were instructed to study carefully 2 case descriptions associated with a particular disease. After each case description participants were asked to provide a diagnosis. Subsequently, they judged whether or not a target item presented on a computer screen was related to the case description. Target items consisted of literally stated signs and symptoms, inferred encapsulated items and filler items.
Results Family doctors provided more accurate diagnoses than Year 2 and Year 4 medical students. Furthermore, family doctors were faster and made fewer errors in judging the relatedness of all item types than Year 2 and 4 medical students. In particular, family doctors showed their best performance on the encapsulated items.
Conclusions The present study showed that encapsulated knowledge becomes increasingly more prominent as expertise develops. For experienced doctors, encapsulated concepts function as the most important building blocks of clinical case representations.