Basic science knowledge underlies clinical science knowledge and clinical problem solving: evidence from veterinary medicine.

ABSTRACT

Medical sciences education emphasizes basic science learning as a prerequisite to clinical learning. Studies exploring relationships between achievement in the basic sciences and subsequent achievement in the clinical sciences generally suggest a significant positive relationship. Basic science knowledge and clinical experience are theorized to combine to form encapsulated knowledge- a dynamic mix of information that is useful for solving clinical problems. This study explores the relationship between basic science knowledge (BSK), clinical science knowledge (CSK), and clinical problem-solving ability, as measured within the context of four veterinary colleges using both college-specific measures and professionally validated, standardized measures of basic and clinical science knowledge and problem-solving ability. Significant correlations existed among all variables. Structural equation modeling and confirmatory factor analysis were used to produce models showing that newly acquired BSK directly and significantly predicted BSK retained over time and newly acquired CSK, as well as indirectly predicted clinical problem-solving ability (mediated by newly acquired CSK and BSK retained over time). These findings likely suggest a gradual development of schema (encapsulated knowledge) and not an isolated development of biomedical versus clinical knowledge over time. A broader implication of these results is that explicitly teaching basic science knowledge positively and durably affects subsequent clinical knowledge and problem-solving ability independent of instructional strategy or curricular approach. Furthermore, for veterinary colleges specifically, student performance as measured by both course-level and standardized tests are likely to prove useful for predicting subsequent academic achievement in classroom and clinical settings, licensing examination performance, and/or for identifying students likely in need of remediation in clinical knowledge.