Analysis of Alternative Strategies for the Teaching of Difficult Threshold Concepts in Large Undergraduate Medicine and Science Classes

Delaney, Sven K; Galea, Anne M.; LeBard, Rebecca; Wilson, John H.; Gibson, Karen J.; Kornfeld, Geoff; Ashraf, Bill

doi:10.1007/s40670-017-0453-x

Cited by 2 publications

(7 citation statements)

References 18 publications

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“…Consistent with the wider literature, 64 there was frequently a lack of evidence to justify the selection of concepts or demonstrate threshold crossing post-intervention. 30,41,43,51,54,55 Therefore, the results of these papers should be interpreted with caution.…”

Section: Methodological Considerationsmentioning

confidence: 93%

“…Thirty-six papers published between 2012 and 2021 were included in the final analysis (see Figure 1 for PRISMA flow diagram). Most papers originated in the United Kingdom (n=15 [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] ), North America (n=11 [36][37][38][39][40][41][42][43][44][45][46] ), and Australasia (n=7 [47][48][49][50][51][52][53] ). Some papers focussed on particular medical specialities and subject areas, including surgery (n=5 21,23,41,50,54 ), medical physiology and biomedical science (n=4 38,39,48,55 ), geriatric medicine and dementia care (n=3 [33][34][35] ), psychiatry (n=2 26,28 ), general practice (n=2 …”

Section: Summary Of Included Studiesmentioning

confidence: 99%

“…Several papers evaluated teaching interventions in the context of the TCF 39,41,48,54,55 and one paper incorporated the TCF into curriculum design of a new course. 31 Other authors took a different approach and examined learning experiences associated with threshold crossing.…”

Section: Use Of the Threshold Concepts Framework In Teachingmentioning

confidence: 99%

“…Most papers originated in the United Kingdom (n = 15 [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] ), North America (n = 11 [36][37][38][39][40][41][42][43][44][45][46] ) and Australasia (n = 7 47-53 ). Some papers focused on particular medical specialities and subject areas, including surgery (n = 5 21,23,41,47,54 ), medical physiology and biomedical science (n = 4 42,43,51,55 ), geriatric medicine and dementia care (n = 3 26,27,29 ), psychiatry (n = 2 24,35 ), general practice (n = 2 34,50 ), military medicine (n = 2 36,37 ), anaesthetics, 46 internal medicine, 39 neurology, 40 paediatrics, 38 palliative care,…”

Section: Summary Of Included Studiesmentioning

confidence: 99%

“…40,42 Potential TCs were identified in relation to physiology and biomedical science, including secondary messenger systems, pressure gradients, preload and afterload, cell membrane potential and polarity. 40,42 Ventilation-perfusion (V/Q) mismatch 46 and an X-ray being a 2D representation of a 3D structure 32 Qualitative study 16 [21][22][23][24][25][26][27][36][37][38][39][40][47][48][49][50] Grounded theory study 5 21,24,36,38,39 Phenomenological study 2 23,26 Ethnographic study 1 22 Naturalistic enquiry 1 25 No specific research design stated 7 27,37,40,[47][48][49][50] Mixed method study 6 28,29,41,51,54,55 Quantitative study 2 30,52 Mixed (conceptual analysis and qualitative study)…”

Section: Basic Conceptual Changementioning

confidence: 99%

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Threshold concepts in medical education: A scoping review

Jones

Hammond

2022

Medical Education

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Introduction The threshold concept framework (TCF) was first described nearly 20 years ago, but its application in the field of medical education has recently seen a significant growth of interest with a diverse range of literature published on the subject. The transformative nature of threshold concepts (TCs) offers potential for the design of learning experiences and curricula across the medical education continuum. A scoping review was conducted to map the extent of the current literature regarding TCs in medical education—to describe the types of available evidence and its focus—and identify research gaps. Methods The review followed the JBI Manual for Evidence Synthesis approach for scoping reviews. Four databases and two additional websites were searched for articles exploring TCs in medical education. Data were analysed using quantitative and qualitative thematic approaches. A framework of conceptual change was used to synthesise the TCs identified. Results Thirty‐six papers, spanning undergraduate, postgraduate and continuing medical education, were included in the final analysis. The most frequent application of the TCF was in the identification of TCs, which related to basic scientific knowledge, ways of thinking and ways of practising in medicine. Uncertainty, patient care, clinical reasoning and professional identify formation were themes that emerged at multiple stages of training. Several papers evaluated the use of the TCF in teaching. Conclusion The understanding and embodiment of TCs increases in complexity across the medical education continuum, with TCs recurring with changes in clinical environment and responsibilities. This lends support to a holistic approach to curriculum design spanning all stages of training. Further research is needed to develop a consistent approach for describing and applying the TCF in medical education and to address how the TCF can be used in teaching and how threshold crossing can be measured.

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