“It’s Always There, Right?” Exploring How Basic Science Knowledge Emerges for Internal Medicine Teams During Inpatient Rounds

• In Event: Unpacking the Black Box: Clinical Reasoning Processes

Abstract

Basic science knowledge (BSK) is a fundamental component of medical school curricula, yet little is known about its roles in the clinical learning environment (CLE). This study examines how BSK manifests in the CLE using a constructivist grounded theory approach. We observed eight inpatient Internal Medicine teams at one US institution. Our data includes 27 hrs of patient rounds observation and 24 30-minute team member interviews. Constant comparative data analysis has shown that BSK emerges from interactions between social, material, and temporal elements of patient care activities and is of a distributed nature. This contrasts with the traditional view of use of BSK as an individual internalized process and provides opportunities to improve preclerkship and clerkship teaching and learning.

Authors

• Tracy Boswell Fulton, University of California - San Francisco

• John Penner, University of California - San Francisco

• Marieke Van der Schaaf, University Medical Centre Utrecht

• Bridget Colleen O'Brien, University of California - San Francisco