A foundational knowledge assessment tool to predict academic performance of medical students in first-year anatomy and physiology.

Misalignments in teaching pedagogies between secondary schools and tertiary institutions have exacerbated educational disparities among students from different backgrounds. Given the variation in students' educational background and competencies, there was a need to develop an Anatomy and Physiology (A&P) Foundational Knowledge Assessment to establish the levels of preparedness of first-year medical students. Previous work that focused on the development of the assessment showed it to be effective in measuring students' foundational knowledge in human anatomy and physiology. The aim of this study was to assess the validity of the A&P Foundational Knowledge Assessment in determining students' prior knowledge and predicting academic performance of first-year students in their anatomy and physiology studies. Three hundred seventy first-year students, across two cohort years, 2017 and 2018, completed the A&P Foundational Knowledge Assessment. Data were analyzed through descriptive statistics, analysis of variance, and Pearson's correlation. Results show that for both cohorts ∼30% of students scored ≤55% and were potentially at risk of performing poorly in their anatomy and physiology studies. Pearson's correlation showed a significant relationship between students' performance on the foundational knowledge assessment and their anatomy and physiology assessments. For both cohorts, >10% of students identified by the A&P Foundational Knowledge Assessment were at risk of either failing the course, entering an extended degree program, or being excluded from the program. Results indicate that the assessment is a good predictor for differentiating medical students' performance in first-year anatomy and physiology.NEW & NOTEWORTHY The development of a foundational knowledge assessment tool to predict academic performance of medical students in first-year anatomy and physiology.

What happens to misunderstandings of biomedical concepts across a medical curriculum?

Research on the extent and nature of commonly misunderstood fundamental biomedical concepts across a medical curriculum is scarce. These misunderstandings could point toward robust misconceptions. We examined first whether common misunderstandings persist throughout a medical curriculum, followed by a fine-grained analysis to identify their nature. We designed and administered a 2-tier test to 987 medical students across our curriculum, with 8 questions covering the respiratory and cardiovascular systems, cell division, and homeostatic processes. Proportions of incorrect responses were computed. Four questions where misunderstandings persisted were further qualitatively analyzed. A one-way ANOVA showed the proportion of incorrect responses decreased significantly by students' academic year [F(6, 986) = 96.05, P < 0.001]. While novices and end-of -first-year students showed similar proportion of incorrect responses (P > 0.05), incorrect responses decreased significantly between first years and second years (P < 0.001). Thereafter, the proportion of incorrect responses remained stable from second to final year (P > 0.05), with ∼35% of incorrect responses. Five questions showed no decrease of incorrect responses between second and final years, with two questions where final year students performed marginally better than novices. A Chi-square analysis, with Bonferroni post hoc test, showed certain misunderstandings appeared frequently across the curriculum. The qualitative analysis of the open-ended questions yielded 15 categories of common misunderstandings of fundamental biomedical concepts in all years of training. If educators become aware of commonly misunderstood biomedical concepts, preventative measures could be taken to prevent robust misconceptions.

First-year medical students' naïve beliefs about respiratory physiology.

The present study explored the nature and frequency of physiology naïve beliefs by investigating novices' understanding of the respiratory system. Previous studies have shown considerable misconceptions related to physiology but focused mostly on specific physiological processes of normal respiration. Little is known about novices' broader understanding of breathing in a clinical context. Our study hypothesized that naïve beliefs could hamper participants' ability to understand the interrelatedness of respiratory structures and functions related to breathing during a clinical complication. The study entailed both quantitative and qualitative foci. A two-tier test was designed and administered to 211 first-year medical students. Participants were asked to choose the correct answer out of a set of four options and to substantiate their choices. Questions were purposefully left open to elicit a wide range of responses. Statistical analysis (SPSS) was done to evaluate the frequency of naïve beliefs. Thematic analysis was used to determine themes within the raw data. The majority of participants selected incorrect answers in the multiple-choice question part of the questionnaire. Results from the thematic analysis yielded a considerable range of naïve beliefs about gas exchange, foundational physics, airflow, anatomic structures, and breathing pathways. An awareness of the existence of such naive beliefs in respiratory physiology will allow educators to address them in their teaching and thereby prevent naïve beliefs transforming into misconceptions.

Exploring lecturers' views of first-year health science students' misconceptions in biomedical domains.

Research has indicated that misconceptions hamper the process of knowledge construction. Misconceptions are defined as persistent ideas not supported by current scientific views. Few studies have explored how misconceptions develop when first year health students conceptually move between anatomy and physiology to construct coherent knowledge about the human body. This explorative study analysed lecturers' perceptions of first-year health science students' misconceptions in anatomy and physiology to gain a deeper understanding of how and why misconceptions could potentially arise, by attempting to link sources of misconceptions with four schools of thought, namely theories on concept formation, complexity, constructivism and conceptual change. This was a qualitative study where ten lecturers involved in teaching anatomy and physiology in the health science curricula at the University of Cape Town were interviewed to explore perceptions of students' misconceptions. Analytical induction was used to uncover categories within the interview data by using a coding system. A deeper analysis was done to identify emerging themes that begins to explore a theoretical understanding of why and how misconceptions arise. Nine sources of misconceptions were identified, including misconceptions related to language, perception, three dimensional thinking, causal reasoning, curricula design, learning styles and moving between macro and micro levels. The sources of misconceptions were then grouped together to assist educators with finding educational interventions to overcome potential misconceptions. This explorative study is an attempt in theory building to understand what is at the core of biomedical misconceptions. Misconceptions identified in this study hold implications for educators as not all students have the required building blocks and cognitive skills to successfully navigate their way through biomedical courses. Theoretical insight into the sources of misconceptions can assist educators in addressing potential hampering factors in the construction of coherent scientific knowledge.

Health Sciences undergraduate education at UCT: a story of transformation.

Undergraduate education and training in the Faculty of Health Sciences at the University of Cape Town has become socially responsive. A story of transformation that is consonant with wider societal developments since the 1994 democratic elections, outlining the changes in undergraduate curricula across the faculty, is presented.

Intervention programme: a supported learning programme for educationally disadvantaged students.

The apartheid system of social engineering in South Africa enforced the segregation of racial groups. It lasted for 50 years, and had an impact on every aspect of society. It particularly affected the education system, resulting in inferior primary and secondary teaching of black learners. Ten years after the dissolution of apartheid, the consequences are still being felt in tertiary institutions. This legacy presents a challenge to South African medical schools, especially at a time of curriculum transformation. This paper describes how the issues of social and educational discrepancies are being addressed at the University of Cape Town.