title: Integration of clinical and basic sciences in concept maps: a mixed-method study on teacher learning.
abstract: BACKGROUND
  The explication of relations between clinical and basic sciences can help vertical integration in medical curricula. Concept mapping might be a useful technique for this explication. Little is known about teachers' ability regarding the articulation of integration. We examined therefore which factors affect the learning of groups of clinicians and basic scientists on different expertise levels who learn to articulate the integration of clinical and basic sciences in concept maps.
  
  
  METHODS
  After a pilot for fine-tuning group size and instructions, seven groups of expert clinicians and basic scientists and seven groups of residents with a similar disciplinary composition constructed concept maps about a clinical problem that fit their specializations. Draft and final concepts maps were compared on elaborateness and articulated integration by means of t-tests. Participants completed a questionnaire on motivation and their evaluation of the instructions. ANOVA's were run to compare experts' and residents' views. Data from video tapes and notes were qualitatively analyzed. Finally, the three data sources were interpreted in coherence by using Pearson's correlations and qualitative interpretation.
  
  
  RESULTS
  Residents outshone experts as regards learning to articulate integration as comparison of the draft and final versions showed. Experts were more motivated and positive about the concept mapping procedure and instructions, but this did not correlate with the extent of integration fond in the concept maps. The groups differed as to communication: residents interacted from the start (asking each other for clarification), whereas overall experts only started interaction when they had to make joint decisions.
  
  
  CONCLUSIONS
  Our results suggest that articulation of integration can be learned, but this learning is not related to participants' motivation or their views on the instructions. Decision making and interaction, however, do relate to the articulation of integration and this suggests that teacher learning programs for designing integrated educational programmes should incorporate co-construction tasks. Expertise level turned out to be decisive for both the level of articulation of integration, the ability to improve the articulated integration and the cooperation pattern.
authors.affiliation: ICLON, Graduate School of Teaching & Leiden University Medical Centre, Wassenaarseweg 62A, 2333 AL, Leiden, The Netherlands. svink@iclon.leidenuniv.nl.
authors.forename: Sylvia C
authors.initials: SC
authors.lastname: Vink
authors.affiliation: Centre for Teaching and Learning, Educational Development and Training, Faculty of Social and Behavioural Sciences, Utrecht University, PO Box 80.140, 3508 TC, Utrecht, The Netherlands. j.vantartwijk@uu.nl.
authors.forename: Jan
authors.initials: J
authors.lastname: Van Tartwijk
authors.affiliation: Leiden University Medical Centre, PO Box 9600, 2300 RC, Leiden, The Netherlands. j.h.bolk@lumc.nl.
authors.forename: Jan
authors.initials: J
authors.lastname: Bolk
authors.affiliation: ICLON, Graduate School of Teaching & Leiden University Medical Centre, Wassenaarseweg 62A, 2333 AL, Leiden, The Netherlands. verloop@iclon.leidenuniv.nl.
authors.forename: Nico
authors.initials: N
authors.lastname: Verloop
mesh_terms: D003142:Communication; D003210:Concept Formation; D003657:Decision Making; D003663:Decision Trees; D006126:Group Processes; D006801:Humans; D007396:Internship and Residency; D009042:Motivation; D018794:Problem-Based Learning / Q000458:organization & administration*; D011361:Professional Competence; D011795:Surveys and Questionnaires; D018511:Systems Integration