Transfer of student learning in medical education

Transfer of learning among the cognitive, psychomotor, and affective domains and among three clinical disciplines--medicine, pediatrics, and surgery--was examined in the final year of a medical student clerkship program. Rather than following the traditional psychological approach, the authors used a model based on ethnographic analysis followed by performance measurement. The general assumption that what students learn in one subject area is transferred to another area was questioned. A total of 120 medical students were assessed in knowledge, skills, and attitudes prior to and after three clinical rotations. The results indicated that learning was discipline-specific as well as specific to the learning domain studied. Therefore, no generalizations can be made from the study of one subject area or one specific aspect of student learning to another. The use of an alternative methodology to study complex behavior rather than the traditional paradigm is suggested.