Document Detail

How expertise develops in medicine: knowledge encapsulation and illness script formation.
MedLine Citation:
PMID:  18004989     Owner:  NLM     Status:  MEDLINE    
CONTEXT: For over 30 years, research has focused on the question of how knowledge is organised in the doctor's mind. The development of encapsulated knowledge, followed by the formation of illness scripts, may both be considered as important stages in the development of medical expertise. METHODS: This paper reviews research on the knowledge encapsulation and illness script hypotheses since their initial formulation. Findings in support of these views of expertise development are reported and conflicting data are discussed. RESULTS: A great deal of empirical data have been collected over the years to investigate the view that, through clinical experiences, biomedical knowledge becomes encapsulated and eventually integrated into illness scripts. The findings of most studies, which have used various techniques to probe the ways by which students and doctors mentally represent clinical cases, are in line with this view of expertise development. However, there is still debate concerning the role of biomedical knowledge in clinical case processing. CONCLUSIONS: To facilitate the development of expertise in medical school, it is important to teach the basic sciences in a clinical context, and to introduce patient problems early in the curriculum in order to support the processes of encapsulation and illness script formation. In addition, during clerkships ample time should be devoted to enabling reflection on patient problems with peers and expert doctors.
Henk G Schmidt; Remy M J P Rikers
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Publication Detail:
Type:  Journal Article; Review     Date:  2007-11-13
Journal Detail:
Title:  Medical education     Volume:  41     ISSN:  0308-0110     ISO Abbreviation:  Med Educ     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-29     Completed Date:  2008-04-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7605655     Medline TA:  Med Educ     Country:  England    
Other Details:
Languages:  eng     Pagination:  1133-9     Citation Subset:  IM    
Department of Psychology, Erasmus University, Rotterdam, The Netherlands.
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MeSH Terms
Clinical Clerkship / methods*
Clinical Competence*
Group Processes
Peer Group
Problem Solving*
Teaching / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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