Pedagogical Approaches with Body Interact | Prior Knowledge
Understanding the role of prior knowledge in human learning is essential for predicting, improving, and explaining competence acquisition.
Bittermann et all, 2023
What is Prior Knowledge?
Prior knowledge refers to the existing knowledge, skills, attitudes, and experiences that learners bring to a new learning situation. In medical education, it shapes how students acquire, process, and apply new medical concepts and contents. Rooted in constructivist and schema theories, prior knowledge supports active learning by integrating new information into pre-existing cognitive structures.
Impact of Limited or Faulty Prior Knowledge on Learning
The lack of inaccurate prior knowledge can significantly hinder medical students’ clinical skills development and new knowledge acquisition:
Delayed clinical skill development
- Slower learning curve due to weak foundational knowledge in anatomy, physiology, and pathology.
- Poor clinical reasoning, making differential diagnoses and decision-making challenging.
- Reduced confidence, leading to hesitation and increased anxiety.
Inefficient knowledge acquisition
- Difficulty integrating new information, causing fragmented comprehension.
- Cognitive overload when new concepts lack a solid foundation.
- Misinterpretation of concepts, resulting in diagnostic and treatment errors or inadequate patient management.
Impact on clinical decision-making
- Higher risk of diagnostic errors and incorrect treatment plans.
- Failure to recognize emergencies, delaying necessary interventions.
- Poor patient communication due to incomplete or incorrect understanding.
Negative effect on long-term learning and adaptability
- Reinforcement of misconceptions that become harder to unlearn later.
- Reduced adaptability, making it difficult to keep up with medical advancements.
Benefits of Integrating Prior Knowledge in Body Interact Virtual Patients
Body Interact is an interactive virtual patient simulation that promotes the development of clinical reasoning, decision-making, and critical thinking skills. Prior knowledge is important in its effectiveness, shaping how learners perceive, interpret, and respond to clinical scenarios.
Considering and activating prior knowledge when implementing learning experiences with Body Interact will:
Improve Clinical Reasoning and Decision-Making
- Pattern Recognition: Learners with strong prior knowledge recognize illness scripts (a) and link symptoms to diagnoses more efficiently.
- Cognitive Load Reduction: According to Sweller’s Cognitive Load Theory (b), prior knowledge allows learners to manage complex variables (vital signs, lab tests, medications) more effectively, freeing cognitive resources for higher-order problem-solving.
Facilitate hypothesis generation and testing
- Learners with prior exposure to disease pathophysiology generate differential diagnoses and test hypotheses systematically.
- Prior clinical experience enables students to anticipate complications and refine their judgment.
Promote safe and experiential learning
- Novice learners with limited prior knowledge may struggle with open-ended decision-making but benefit from, as Kolb mentioned, experiential learning (c). Through trial and error, with Body Interact, they build mental models that reinforce theoretical knowledge.
- Conversely, advanced learners maximize prior knowledge to refine skills, experiment with different clinical approaches, and practice critical thinking under time constraints.
Overcome misconceptions and errors
- Virtual patients help students test assumptions and adjust based on real-time feedback.
- Immediate feedback fosters correcting errors in clinical reasoning and reinforces accurate knowledge.
Bridge the gap between theory and practice
- Supports students transitioning from preclinical to clinical training by integrating basic sciences with real-world patient care.
- For experienced practitioners, it enhances decision-making under pressure in realistic clinical scenarios.
Support Competency-Based Medical Education (CBME)
- Prior knowledge determines how effectively learners progress through CBME milestones (e.g. differential diagnosis, patient management).
- Body Interacts’ wide library of clinical scenarios with a range of difficulty levels promotes an adjusted learning experience, ensuring personalized learning based on prior experience.
Best Practice for Integrating Prior Knowledge with Body Interact
To maximize learning, educators should:
1. Assess students’ prior knowledge before introducing content
Students have varying prior knowledge levels, affecting their engagement with new content. Identifying these differences helps educators tailor instruction effectively or propose supplementary resources to balance students’ prior knowledge.
2. Activate prior knowledge before introducing new content
Activating prior knowledge helps students recall relevant information, making it easier to integrate new concepts.
3. Correct misconceptions early
Inaccurate prior knowledge can misguide learning and result in erroneous clinical reasoning.
4. Scaffold learning based on prior knowledge
The Cognitive Load Theory suggests that structured scaffolding (d) helps students manage complex clinical information.
5. Personalize learning based on prior knowledge
Learners progress at different rhythms. Personalizing instruction enhances engagement and efficiency in new knowledge acquisition.
6. Encourage reflection
Reflection helps learners connect new experiences with prior knowledge.
7. Resources curation
Select Body Interact scenarios that match the curriculum requirements and students’ proficiency levels.
Guiding Questions for Educators
We propose that educators reflect on some points. So, after selecting a Body Interact scenario ask yourself the following questions aiming to promote a smooth integration of prior knowledge and deeper skills development:
- What key prior knowledge is required for this scenario?
- Do students have the necessary foundational knowledge and skills?
- How can I assess students’ prior knowledge (self-assessment, class-wide assessment)?
- What preparatory work can students do to activate or balance prior knowledge?
- What pre-activities (readings, case reviews, Body Interact cases) will help students engage effectively?
- How can I validate that students have acquired the foundational knowledge needed for more complex learning experiences?
Indeed, prior knowledge…has long been known to explain large portions of variance in learning outcomes.
Brod, 2021
The lack of prior knowledge and misconceptions pose risks to medical students’ learning and clinical development. By strategically addressing these gaps, educators can enhance learning efficiency, clinical reasoning, and patient safety.
Activating prior knowledge in virtual patient simulations fosters better decision-making, improves retention, and builds confidence. Proper integration of Body Interact in medical education ensures students develop the necessary competence for effective clinical practice.
(a) Illness Scripts – These are mental representations that clinicians develop over time to recognize and diagnose diseases efficiently. These scripts are cognitive structures that organize knowledge about diseases, including their presentation, causes, and management. They help clinicians recognize patterns in patient cases and make rapid, informed decisions.
(b) Cognitive Load Theory – This suggests that our working memory is only able to hold a small amount of information at any time and that instructional methods should avoid overloading it to maximize learning.
(c) Experiential Learning Theory – The theory by David A. Kolb describes how people learn through experience. According to this theory, the ideal process of learning occurs in a 4 step experiential learning cycle: experiencing, reflecting, thinking, and acting.
(d) Scaffolding – Emphasizes that learners perform better with temporary guidance until they can manage tasks autonomously
References
Bittermann, A., McNamara, D., Simonsmeier, B.A. et al. The Landscape of Research on Prior Knowledge and Learning: a Bibliometric Analysis. Educ Psychol Rev 35, 58 (2023). https://doi.org/10.1007/s10648-023-09775-9
Brod, G. Toward an understanding of when prior knowledge helps or hinders learning. npj Sci. Learn. 6, 24 (2021). https://doi.org/10.1038/s41539-021-00103-w
Kiesewetter, J., Sailer, M., Jung, V.M. et al. Learning clinical reasoning: how virtual patient case format and prior knowledge interact. BMC Med Educ 20, 73 (2020). https://doi.org/10.1186/s12909-020-1987-y
Kolb, D. A. (1984). Experiential Learning: Experience as the Source of Learning and Development. Englewood Cliffs, NJ: Prentice Hall. ISBN: 0132952610
Nivala, M., Paranko, J., Gruber, H. et al. The Role of Prior Knowledge and Students’ Perceptions in Learning of Biomedical Sciences. Med.Sci.Educ. 26, 631–638 (2016). https://doi.org/10.1007/s40670-016-0319-7
Sweller, J. (1988). Cognitive Load during Problem Solving: Effects on Learning. Cognitive Science, 12, p.257-285.
Young, J. Q., Van Merrienboer, J., Durning, S., & Ten Cate, O. (2014). Cognitive Load Theory: Implications for medical education: AMEE Guide No. 86. Medical Teacher, 36(5), 371–384. https://doi.org/10.3109/0142159X.2014.889290
