Searching for Basic Science Knowledge Use in Clinical Learning and Teaching Practice: Studies of Medical Students, Teams, and Educators

Abstract

This thesis examines how basic science knowledge is understood, engaged with, and sustained within medical education and practice. Using an interpretivist approach, it explores how different actors across the educational continuum make meaning of basic science knowledge in relation to patient care, professional identity, and educational practice. Across four qualitative studies, the findings demonstrate that use of basic science knowledge is shaped by beliefs about relevance, social interactions, contextual affordances, and distributions of responsibility. Taken together, the thesis highlights the dynamic and situated nature of basic science knowledge in medical education and offers an account of how connections between basic science knowledge, clinical knowledge and patient care are recognized, activated, deferred, or cultivated across learners, clinicians, teams, and basic science medical educators. This work affirms the importance of basic science knowledge while attending to persistent tensions in framing it as both foundational and integrated. It advances two conceptual contributions. First, meaningful integration of basic science and clinical knowledge is shown to be a fundamentally social and distributed process, rather than an individual cognitive accomplishment. Second, basic science medical educators integrate their own knowledge and shape their identities through practice, in bidirectional interactions with educators and students. Through this work they play a critical role in shaping how basic science knowledge is constructed, sustained, and valued within medical education. By viewing medical education and the clinical learning environment as social learning landscapes, this thesis examines how basic science knowledge is constructed and used in practice, and how this understanding can be leveraged to inform curriculum design, faculty development, and medical educator identity formation, with implications for improving learning and, ultimately, patient care.