title: Phenomenographic study of basic science understanding-senior medical students' conceptions of fatigue.
abstract: BACKGROUND
  Helping students learn to apply their newly learned basic science knowledge to clinical situations is a long-standing challenge for medical educators. This study aims to describe how medical students' knowledge of the basic sciences is construed toward the end of their medical curriculum, focusing on how senior medical students explain the physiology of a given scenario. Methods A group of final-year medical students from two universities was investigated. Interviews were performed and phenomenographic analysis was used to interpret students' understanding of the physiology underlying the onset of fatigue in an individual on an exercise bicycle.
  
  
  RESULTS
  Three categories of description depict the qualitatively different ways the students conceptualized fatigue. A first category depicts well integrated physiological and bio-chemical knowledge characterized by equilibrium and causality. The second category contains conceptions of finite amount of substrate and juxtaposition of physiological concepts that are not fully integrated. The third category exhibits a fragmented understanding of disparate sections of knowledge without integration of basic science and clinical knowledge.
  
  
  CONCLUSIONS
  Distinctive conceptions of fatigue based with varying completeness of students' understanding characterized the three identified categories. The students' conceptions of fatigue were based on varying understanding of how organ systems relate and of the thresholds that determine physiological processes. Medical instruction should focus on making governing steps in biological processes clear and providing opportunity for causal explanations of clinical scenarios containing bio-chemical as well as clinical knowledge. This augments earlier findings by adding descriptions in terms of the subject matter studied about how basic science is applied by students in clinical settings.
authors.affiliation: Department of Learning, Centre for Medical Education, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Niklas
authors.initials: N
authors.lastname: Wilhelmsson
authors.forename: Lars Owe
authors.initials: LO
authors.lastname: Dahlgren
authors.forename: Håkan
authors.initials: H
authors.lastname: Hult
authors.forename: Staffan
authors.initials: S
authors.lastname: Wirell
authors.forename: Torbjörn
authors.initials: T
authors.lastname: Ledin
authors.forename: Anna
authors.initials: A
authors.lastname: Josephson
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004504:Education, Medical, Undergraduate; D005221:Fatigue / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D018794:Problem-Based Learning; D036301:Qualitative Research; D013337:Students, Medical; D013548:Sweden; D055815:Young Adult