Wilson Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Centre for Ambulatory Care Education, University of Toronto, Toronto, Ontario, Canada.
Med Educ. 2018 Jun;52(6):592-604. doi: 10.1111/medu.13519. Epub 2018 Feb 8.
'Transfer' is the application of a previously learned concept to solve a new problem in another context. Transfer is essential for basic science education because, to be valuable, basic science knowledge must be transferred to clinical problem solving. Therefore, better understanding of interventions that enhance the transfer of basic science knowledge to clinical reasoning is essential. This review systematically identifies interventions described in the health professions education (HPE) literature that document the transfer of basic science knowledge to clinical reasoning, and considers teaching and assessment strategies.
A systematic search of the literature was conducted. Articles related to basic science teaching at the undergraduate level in HPE were analysed using a 'transfer out'/'transfer in' conceptual framework. 'Transfer out' refers to the application of knowledge developed in one learning situation to the solving of a new problem. 'Transfer in' refers to the use of previously acquired knowledge to learn from new problems or learning situations.
Of 9803 articles initially identified, 627 studies were retrieved for full text evaluation; 15 were included in the literature review. A total of 93% explored 'transfer out' to clinical reasoning and 7% (one article) explored 'transfer in'. Measures of 'transfer out' fostered by basic science knowledge included diagnostic accuracy over time and in new clinical cases. Basic science knowledge supported learning - 'transfer in' - of new related content and ultimately the 'transfer out' to diagnostic reasoning. Successful teaching strategies included the making of connections between basic and clinical sciences, the use of commonsense analogies, and the study of multiple clinical problems in multiple contexts. Performance on recall tests did not reflect the transfer of basic science knowledge to clinical reasoning.
Transfer of basic science knowledge to clinical reasoning is an essential component of HPE that requires further development for implementation and scholarship.
“迁移”是将先前学到的概念应用于解决另一种情境下的新问题。迁移对于基础科学教育至关重要，因为基础科学知识要具有价值，就必须迁移到临床问题解决中。因此，更好地理解增强基础科学知识向临床推理迁移的干预措施至关重要。本综述系统地确定了健康职业教育（HPE）文献中描述的干预措施，这些措施记录了基础科学知识向临床推理的迁移，并考虑了教学和评估策略。
对文献进行了系统搜索。使用“迁移出”/“迁移入”概念框架分析了 HPE 中与基础科学教学相关的文章。“迁移出”是指将在一个学习情境中获得的知识应用于解决新问题。“迁移入”是指利用先前获得的知识从新问题或学习情境中学习。
在最初确定的 9803 篇文章中，有 627 篇文章进行了全文评估；其中 15 篇被纳入文献综述。总共 93%的文章探索了基础科学知识向临床推理的“迁移出”，而 7%（一篇文章）探索了“迁移入”。基础科学知识促进了“迁移出”到诊断推理的诊断准确性的时间和新临床病例的提高。基础科学知识支持学习——“迁移入”——新的相关内容，最终是“迁移出”到诊断推理。成功的教学策略包括在基础科学和临床科学之间建立联系、使用常识类比以及在多个上下文中研究多个临床问题。回忆测试的表现并不能反映基础科学知识向临床推理的迁移。
将基础科学知识迁移到临床推理是 HPE 的一个重要组成部分，需要进一步发展实施和学术研究。
