The experienced diagnostician can rely on two basic forms of knowledge - clinical knowledge (the signs, symptoms and associated findings of disease) and biomedical knowledge (the basic mechanisms and functioning of the human body). There is general agreement among medical educators that both forms of knowledge should be essential components of medical curricula. However, while the value of clinical knowledge is self-evident, the role of biomedical knowledge remains unclear. Early research in clinical reasoning found little evidence to support the use of basic science knowledge in routine diagnosis. The question for medical educators today is whether training in the basic biomedical sciences is a valuable addition to the clinical experience that students will come to depend upon throughout their careers.
My work examines the role biomedical knowledge in clinical reasoning and value of basic science training in the development of medical expertise. Applying principles of memory and learning to medical education, I have begun to look beyond the problem-solving aspect of diagnosis to the cognitive resources that support clinical reasoning. My research has found a role for basic science knowledge in creating a conceptual framework for clinical information. By providing explanatory pathways and causal connections between signs and symptoms, basic science knowledge can help students develop a coherent mental representation of a disease category. This type of mental representation plays a critical role in long-term memory, knowledge transfer and solving challenging clinical problems. Building on this basic premise, my research program focuses on 1) the design of instructional methods that integrate clinical knowledge and conceptual models of disease 2) the evaluation of basic science knowledge and 3) understanding the changing role of biomedical knowledge throughout undergraduate, postgraduate and continuing education.