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"It's Always There, Right?" Exploring Internal Medicine Teams' Use of Basic Science Knowledge on Inpatient Rounds.

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Area of Science:

  • Medical Education
  • Internal Medicine
  • Clinical Reasoning

Background:

  • Basic science knowledge (BSK) is crucial for clinical practice and learning.
  • Evidence on how BSK is applied in clinical learning environments (CLEs) is limited.
  • Understanding BSK integration in the workplace is essential for medical education.

Purpose of the Study:

  • To characterize the use of BSK during patient care in an inpatient Internal Medicine CLE.
  • To identify actions, interactions, materials, and beliefs influencing BSK use.
  • To inform strategies for connecting BSK education with clinical learning and patient care.

Main Methods:

  • Constructivist grounded theory study.
  • Data collected from eight inpatient Internal Medicine teams.
  • Included 27 hours of observation and 24 team member interviews.

Main Results:

  • BSK activation occurs through social interactions and engagement with materials like EHRs.
  • Activation is linked to connecting with and testing BSK or exploring uncertainty.
  • Barriers include beliefs about BSK not fitting patient care, leading to delegation or curtailed discussions.

Conclusions:

  • BSK use in clinical settings is shaped by social and material factors within the CLE, extending beyond individual cognition.
  • Leveraging these elements can enhance BSK activation.
  • This integration supports the connection between learning and patient care in the workplace.