Misconceived Causal Explanations for Emergent Processes

Misconceptions about Oral Diagnosis and Radiology among Dental Students: A Questionnaire Study

BACKGROUND

Misconceptions are learning deficits that may cause clinical judgments in a dental practice to be made incorrectly.

AIM

This study aimed to identify and look into students' misconceptions regarding Oral Diagnosis and Radiology.

MATERIALS AND METHODS

The fourth and fifth-grade students at the Altınbaş University Faculty of Dentistry were given a self-administered questionnaire that included multiple-choice questions about Oral Diagnosis/Medicine and Radiology. 106 students participated in the questionnaire and 50.9% of the participants were fourth-grade students, 49.1% of them were fifth-grade students. The questions were classified into two parts: five scenario-based questions and ten knowledge-based questions. Students' replies were evaluated for accuracy and confidence, and when a student was certain of giving an inaccurate response, misconceptions were noted. Two groups were compared using the Mann-Whitney-U test (P = 0.05).

RESULTS

A total of 1590 responses were collected. Regarding the question type, scenario-based questions had more misconceptions (19.6%) than knowledge-based questions (18.4%). Depending on the question, the majority of misconceptions were seen in the questions about denture stomatitis (46.2%) and radiographic contrast (38.7%).

CONCLUSIONS

To prevent misdiagnosis, it is essential to recognize and overcome misconceptions in Oral Diagnosis/Medicine and Radiology. Therefore this study assists students and lecturers in defining misconceptions and organizing precautions to avoid and fix them.

Thinking in Terms of Change over Time: Opportunities and Challenges of Using System Dynamics Models

Understanding the world around us is a growing necessity for the whole public, as citizens are required to make informed decisions in their everyday lives about complex issues. Systems thinking (ST) is a promising approach for developing solutions to various problems that society faces and has been acknowledged as a crosscutting concept that should be integrated across educational science disciplines. However, studies show that engaging students in ST is challenging, especially concerning aspects like change over time and feedback. Using computational system models and a system dynamics approach can support students in overcoming these challenges when making sense of complex phenomena. In this paper, we describe an empirical study that examines how 10th grade students engage in aspects of ST through computational system modeling as part of a Next Generation Science Standards-aligned project-based learning unit on chemical kinetics. We show students' increased capacity to explain the underlying mechanism of the phenomenon in terms of change over time that goes beyond linear causal relationships. However, student models and their accompanying explanations were limited in scope as students did not address feedback mechanisms as part of their modeling and explanations. In addition, we describe specific challenges students encountered when evaluating and revising models. In particular, we show epistemological barriers to fruitful use of real-world data for model revision. Our findings provide insights into the opportunities of a system dynamics approach and the challenges that remain in supporting students to make sense of complex phenomena and nonlinear mechanisms.

The Impact of Context on Students' Framing and Reasoning about Fluid Dynamics

Contextual features of assessments can influence the ideas students draw from and the ways they assemble knowledge. We used a mixed-methods approach to explore how surface-level item context impacts student reasoning. In study 1, we developed an isomorphic survey to capture student reasoning about fluid dynamics, a crosscutting phenomenon, in two item contexts (blood vessels, water pipes), and administered the survey to students in two different course contexts: human anatomy and physiology (HA&P) and physics. We observed a significant difference in two of 16 between-context comparisons and a significant difference in how HA&P students responded to our survey compared with physics students. In study 2, we conducted interviews with HA&P students to explore our findings from study 1. Using the resources and framing theoretical framework, we found that HA&P students responding to the blood vessel protocol used teleological cognitive resources more frequently compared with HA&P students responding to the water pipes version. Further, students reasoning about water pipes spontaneously introduced HA&P content. Our findings support a dynamic model of cognition and align with previous work suggesting item context impacts student reasoning. These results also underscore a need for instructors to recognize the impact of context on student reasoning about crosscutting phenomena.

Oaks to arteries: the Physiology Core Concept of flow down gradients supports transfer of student reasoning

The Physiology Core Concept of flow down gradients is a major concept in physiology, as pressure gradients are the key driving force for the bulk flow of fluids in biology. However, students struggle to understand that this principle is foundational to the mechanisms governing bulk flow across diverse physiological systems (e.g., blood flow, phloem sap flow). Our objective was to investigate whether bulk flow items that differ in scenario context (i.e., taxa, amount of scientific terminology, living or nonliving system) or in which aspect of the pressure gradient is kept constant (i.e., starting pressure or pressure gradient) influence undergraduate students' reasoning. Item scenario context did not impact the type of reasoning students used. However, students were more likely to use the Physiology Core Concept of "flow down [pressure] gradients" when the pressure gradient was kept constant and less likely to use this concept when the starting pressure was kept constant. We also investigated whether item scenario context or which aspect of the pressure gradient is kept constant impacted how consistent students were in the type of reasoning they used across two bulk flow items on the same homework. Most students were consistent across item scenario contexts (76%) and aspects of the pressure gradient kept constant (70%). Students who reasoned using "flow down gradients" on the first item were the most consistent (86, 89%), whereas students using "pressures indicate (but don't cause) flow" were the least consistent (43, 34%). Students who are less consistent know that pressure is somehow involved or indicates fluid flow but do not have a firm grasp of the concept of a pressure gradient as the driving force for fluid flow. These findings are the first empirical evidence to support the claim that using Physiology Core Concept reasoning supports transfer of knowledge across different physiological systems.NEW & NOTEWORTHY These findings are the first empirical evidence to support the claim that using Physiology Core Concept reasoning supports transfer of knowledge across different physiological systems.

Undergraduate students' neurophysiological reasoning: what we learn from the attractive distractors students select

The basis for mastering neurophysiology is understanding ion movement across cell membranes. The Electrochemical Gradients Assessment Device (EGAD) is a 17-item test assessing students' understanding of fundamental concepts of neurophysiology, e.g., electrochemical gradients and resistance, synaptic transmission, and stimulus strength. We collected responses to the EGAD from 534 students from seven institutions nationwide, before and after instruction. We determined the relative difficulty of neurophysiology topics and noted that students did better on "what" questions compared to "how" questions, particularly those integrating concentration gradient and electric forces to predict ion movement. We also found that, even after instruction, students selected one incorrect answer, at a rate greater than random chance for nine questions. We termed these incorrect answers attractive distractors. Most attractive distractors contained terms associated with concentration gradients, equilibrium, or anthropomorphic and teleological reasoning, and incorrect answers containing multiple terms were more attractive. We used χ² analysis and alluvial diagrams to investigate how individual students moved or did not move between answer choices on the pre- and posttest. Interestingly, students selecting the attractive distractor on the pretest were just as likely as other incorrect students to move to the correct answer on the posttest. In contrast, of students incorrect on both the pre- and posttest, students who selected the attractive distractor on the pretest were more likely to stick with this answer on the posttest than students choosing other incorrect answers. Combining the EGAD results with alluvial diagrams can inform neurophysiology instruction to address points of student confusion.NEW & NOTEWORTHY Investigating students' alternative reasoning in neurophysiology, this research is the first to investigate how analyzing the most common incorrect answer can shed light on the concepts students struggle with when reasoning about neurophysiological problems, especially those dealing with both chemical and electrical driving forces to predict ion movement across cell membranes.

What a Difference in Pressure Makes! A Framework Describing Undergraduate Students' Reasoning about Bulk Flow Down Pressure Gradients

Pressure gradients serve as the key driving force for the bulk flow of fluids in biology (e.g., blood, air, phloem sap). However, students often struggle to understand the mechanism that causes these fluids to flow. To investigate student reasoning about bulk flow, we collected students' written responses to assessment items and interviewed students about their bulk flow ideas. From these data, we constructed a bulk flow pressure gradient reasoning framework that describes the different patterns in reasoning that students express about what causes fluids to flow and ordered those patterns into sequential levels from more informal ways of reasoning to more scientific, mechanistic ways of reasoning. We obtained validity evidence for this bulk flow pressure gradient reasoning framework by collecting and analyzing written responses from a national sample of undergraduate biology and allied health majors from 11 courses at five institutions. Instructors can use the bulk flow pressure gradient reasoning framework and assessment items to inform their instruction of this topic and formatively assess their students' progress toward more scientific, mechanistic ways of reasoning about this important physiological concept.

Understanding Homeostatic Regulation: The Role of Relationships and Conditions in Feedback Loop Reasoning

Understanding homeostasis is a goal of biology education curricula, as homeostasis is a core feature of living systems. Identifying and understanding the underlying molecular feedback mechanisms appear to be challenging for students. Understanding the properties and mechanisms of such complex homeostatic systems requires feedback loop reasoning, which is a part of systems thinking. Novices seem to struggle to 1) consider more than one initiating condition in cause-effect relationships and 2) track cause and effect across a sequence of processes. In this cross-sectional study, we analyzed how these factors impede feedback loop reasoning. High school and undergraduate students analyzed the organizational, behavioral, and modeling-related features of a homeostatic system (blood calcium regulation). Using multidimensional item response theory, we were able to confirm the three-dimensional structure of the theoretical systems-thinking model and to identify the factors causing item difficulty. As hypothesized, indirect relationships and derived inverse conditions are challenging factors for participants in the context of homeostasis across dimensions. Hence, we recommend paying special attention to these factors when teaching homeostasis as part of systems thinking. We assume that allowing students to reason from different initiating conditions in a learning setting may improve their systems-thinking skills.

Intuitive concepts in internal medicine and their occurrence in undergraduate medical students in different semesters

Background: Dealing with errors in medical practice is of great importance for patient safety. In the natural sciences, intuitive concepts, so-called misconceptions, are increasingly coming into focus of teaching because they lead to a faulty understanding of contexts and thus to faulty scientific reasoning. In medicine, intuitive concepts still play a subordinate role. However, once intuitive concepts have been memorized, they can become firmly established and, under certain circumstances, lead to diagnostic and treatment errors in medical practice. The aim of this study was to identify potential intuitive concepts in internal medicine and to analyze their occurrence in medical students from different semesters. Methods: Eight internists from different subspecialties were asked about intuitive concepts by means of a structured interview. A total of 17 intuitive concepts were identified. Using these concepts, a multiple-choice test was created with 17 patient cases. For each case, there were four possible answers: the correct answer, an incorrect answer that included the intuitive concept, the answer "both are incorrect", and the answer "I am not sure", which is to be understood in the sense of "I do not know whether one of the three answers is correct". As an online multiple-choice test, these 17 cases were made available to all 2^nd, 6^th, and 12^th semester students (N=1170, n=418 from the 2nd semester, n=425 from the 6^th semester, and n=327 from the 12^th semester, i.e., the final year) for four weeks in June 2015. The test had to be answered within nine minutes. A mixed logistic regression model was used for evaluation. Results: Of the N=317 participating students (n=97 from the 2^nd semester, n=124 from the 6^th semester, and n=96 from the internship year, overall response rate 27.1%), on average, students from all three groups chose the intuitive concept most often, approximately 40%, although the correct answer increased toward the final year with simultaneously decreasing uncertainty and decreasing feeling of not knowing, respectively. In the final year, compared to the 2^nd semester, the intuitive concept was selected significantly more often for two questions (p<0.01). For four questions, the intuitive concept was selected significantly less frequently in the final year (p<0.01). Conclusion: Intuitive concepts can be identified in internal medicine and do not appear to be significantly reduced in students during the course of their studies. This suggests that this could also be the case for other medical subjects. Therefore, similar studies should be conducted for other medical subjects in order to identify potential sources of error in clinical work. In addition, suitable didactic methods should be developed and tested with which students learn not to succumb to intuitive concepts as far as possible in order to prevent diagnostic or therapeutic errors in later medical practice.

The Substance of Cold: Indonesians' Use of Cold Weather Theory to Explain Everyday Illnesses

Many people across the world use cold conditions, such as cold air and wet clothes, to explain everyday illness, such as colds and flu. In Indonesia, the concept masuk angin, or "trapped wind," appears to reflect this line of folknatural thinking. Interestingly, Indonesians distinguish masuk angin from the common cold, which is a frequent target for "cold weather" explanations in other cultures. We interviewed Indonesian 8- and 10-year-old children, lay adults, and medical expert adults, about the cause, contagiousness, and treatment of everyday illnesses: the common cold, the flu, and masuk angin. Most Indonesian children, and especially adults, believed that cold and flu are caused by germs and are contagious. In contrast, most children and lay adults (but not experts) attributed masuk angin to cold conditions and viewed it as non-contagious. These findings reveal how folknatural and scientific theories of illness coexist in the minds of Indonesian children and lay adults.

Identifying misconceptions about oral radiology and medicine among dental students

PURPOSE/OBJECTIVES

Misconceptions are learning deficiencies that can lead to inappropriate clinical decision-making in dental practice. Although misconceptions are common among students, they are rarely analyzed in dental education. Thus, this study aimed to identify and analyze students' misconceptions about oral radiology and medicine at a Brazilian dental school.

METHODS

Between October 2019 and March 2020, a self-administered anonymous questionnaire was distributed to dental students at the Federal University of Pernambuco, Brazil, which comprised multiple-choice questions about oral radiology and medicine. The questions were divided into two groups: 10 knowledge-based questions (less demand for reasoning) and five scenario-based questions (higher demand for reasoning). The students' responses were assessed for correctness (correct or incorrect) and confidence (sure or unsure), while misconceptions were identified when a student was sure of an incorrect response. Pearson's chi-square test was used to analyze the variables (α = 0.05).

RESULTS

A total of 1380 responses were collected. Misconceptions represented 24.3% (n = 336) of the total responses and 56.8% of the incorrect responses. The mean misconceptions per student were 3.7 (range, 0-8). Students who chose incorrect answers tended to have higher confidence levels (p < 0.001). Moreover, misconceptions were more frequent for scenario-based questions (25.7%) than for knowledge-based questions (23.7%) (p = 0.000).

CONCLUSION

A large number of misconceptions existed among participants. Our findings will aid educators and students in identifying misconceptions and planning measures to prevent and correct them.

Developing an Understanding of Science

Young children are adept at several types of scientific reasoning, yet older children and adults have difficulty mastering formal scientific ideas and practices. Why do “little scientists” often become scientifically illiterate adults? We address this question by examining the role of intuition in learning science, both as a body of knowledge and as a method of inquiry. Intuition supports children's understanding of everyday phenomena but conflicts with their ability to learn physical and biological concepts that defy firsthand observation, such as molecules, forces, genes, and germs. Likewise, intuition supports children's causal learning but provides little guidance on how to navigate higher-order constraints on scientific induction, such as the control of variables or the coordination of theory and data. We characterize the foundations of children's intuitive understanding of the natural world, as well as the conceptual scaffolds needed to bridge these intuitions with formal science.

One Instructional Sequence Fits all? A Conceptual Analysis of the Applicability of Concreteness Fading in Mathematics, Physics, Chemistry, and Biology Education

To help students acquire mathematics and science knowledge and competencies, educators typically use multiple external representations (MERs). There has been considerable interest in examining ways to present, sequence, and combine MERs. One prominent approach is the concreteness fading sequence, which posits that instruction should start with concrete representations and progress stepwise to representations that are more idealized. Various researchers have suggested that concreteness fading is a broadly applicable instructional approach. In this theoretical paper, we conceptually analyze examples of concreteness fading in the domains of mathematics, physics, chemistry, and biology and discuss its generalizability. We frame the analysis by defining and describing MERs and their use in educational settings. Then, we draw from theories of analogical and relational reasoning to scrutinize the possible cognitive processes related to learning with MERs. Our analysis suggests that concreteness fading may not be as generalizable as has been suggested. Two main reasons for this are discussed: (1) the types of representations and the relations between them differ across different domains, and (2) the instructional goals between domains and subsequent roles of the representations vary.

When fiction becomes fact: exaggerating host manipulation by parasites

In an era where some find fake news around every corner, the use of sensationalism has inevitably found its way into the scientific literature. This is especially the case for host manipulation by parasites, a phenomenon in which a parasite causes remarkable change in the appearance or behaviour of its host. This concept, which has deservedly garnered popular interest throughout the world in recent years, is nearly 50 years old. In the past two decades, the use of scientific metaphors, including anthropomorphisms and science fiction, to describe host manipulation has become more and more prevalent. It is possible that the repeated use of such catchy, yet misleading words in both the popular media and the scientific literature could unintentionally hamper our understanding of the complexity and extent of host manipulation, ultimately shaping its narrative in part or in full. In this commentary, the impacts of exaggerating host manipulation are brought to light by examining trends in the use of embellishing words. By looking at key examples of exaggerated claims from widely reported host-parasite systems found in the recent scientific literature, it would appear that some of the fiction surrounding host manipulation has since become fact.

Design-Based Research: A Methodology to Extend and Enrich Biology Education Research

Recent calls in biology education research (BER) have recommended that researchers leverage learning theories and methodologies from other disciplines to investigate the mechanisms by which students to develop sophisticated ideas. We suggest design-based research from the learning sciences is a compelling methodology for achieving this aim. Design-based research investigates the "learning ecologies" that move student thinking toward mastery. These "learning ecologies" are grounded in theories of learning, produce measurable changes in student learning, generate design principles that guide the development of instructional tools, and are enacted using extended, iterative teaching experiments. In this essay, we introduce readers to the key elements of design-based research, using our own research into student learning in undergraduate physiology as an example of design-based research in BER. Then, we discuss how design-based research can extend work already done in BER and foster interdisciplinary collaborations among cognitive and learning scientists, biology education researchers, and instructors. We also explore some of the challenges associated with this methodological approach.

Relational Scaffolding Enhances Children’s Understanding of Scientific Models

Models are central to the practice and teaching of science. Yet people often fail to grasp how scientific models explain their observations of the world. Realizing the explanatory power of a model may require aligning its relational structure to that of the observable phenomena. In the present study, we tested whether relational scaffolding—guided comparisons between observable and modeled events—enhances children’s understanding of scientific models. We tested relational scaffolding during instruction of third graders about the day/night cycle, a topic that involves relating Earth-based observations to a space-based model of Earth’s rotation. Experiment 1 found that participants ( N = 108) learned more from instruction that incorporated relational scaffolding. Experiment 2 ( N = 99) found that guided comparison—not merely viewing observable and modeled events—is a critical component of relational scaffolding, especially for children with low initial knowledge. Relational scaffolding could be applied broadly to assist the many students who struggle with science.

Molecular Concepts Adaptive Assessment (MCAA) Characterizes Undergraduate Misconceptions about Molecular Emergence

This paper discusses the results of two experiments assessing undergraduate students' beliefs about the random nature of molecular environments. Experiment 1 involved the implementation of a pilot adaptive assessment ( n = 773) and focus group discussions with undergraduate students enrolled in first- through third-year biology courses; experiment 2 involved the distribution of the redesigned adaptive assessment to the same population of students in three consecutive years ( n = 1170). The overarching goal of the study was to provide a detailed characterization of learners' perceptions and beliefs regarding molecular agency, environments, and diffusion and whether or not those beliefs change over time. Our results indicated that advanced learners hold as many misconceptions as novice learners and that confidence in their misconceptions increases as they advance through their undergraduate education. In particular, students' understanding of random/Brownian motion is complex and highly contextual, suggesting that the way in which we teach biology does not adequately remediate students' preconceived notions of molecular agency and may actually reinforce them.

Informing the uninformed: a multitier approach to uncover students' misconceptions on cardiovascular physiology

Misconceptions about physiology are a major threat to accurate scientific and clinical reasoning in medical education. Awareness is often mentioned as a prerequisite to achieve conceptual understanding; however, students are frequently unaware of their incorrect understanding. We explored the multitier approach as a tool to obtain insight into students' awareness and misconceptions regarding cardiovascular physiology. Biomedical sciences students ( N = 81) participated in a diagnostic multitier assessment on cardiovascular physiology. Each question consisted of an answer tier and an explanation tier. Both tiers were paired with confidence tiers, i.e., 5-point Likert scales, which were used as an indicator for metacognitive evaluation, i.e., awareness. The average test score was 3.07 (maximum 4.0) for the answer tier only, and reduced to 1.57 when answer and explanation tiers were combined. A weak correlation ( R² = 0.13, P = 0.001) between students' confidence and their test scores was found for the combined responses. Correct combined answers were associated with an increase in confidence score of 0.27 vs. incorrect answers. Using a Bland-Altman analysis, we showed that students generally overestimated their knowledge. In total, 28.7% of all responses were classified as misconceptions, defined as incorrect answers paired with high confidence. In all, findings indicate that the multitier approach is useful to study students' conceptual understanding and uncover misconceptions on cardiovascular physiology. Furthermore, this study supports the need for metacognitive measures in order to improve teaching and learning in medical education.

Successful structure learning from observational data

Previous work suggests that humans find it difficult to learn the structure of causal systems given observational data alone. We identify two conditions that enable successful structure learning from observational data: people succeed if the underlying causal system is deterministic, and if each pattern of observations has a single root cause. In four experiments, we show that either condition alone is sufficient to enable high levels of performance, but that performance is poor if neither condition applies. A fifth experiment suggests that neither determinism nor root sparsity takes priority over the other. Our data are broadly consistent with a Bayesian model that embodies a preference for structures that make the observed data not only possible but probable.

Developing an Analytical Framework to Characterize Student Reasoning about Complex Processes

Real-world processes are complex and require ideas from multiple disciplines to be explained. However, many science courses offer limited opportunities for students to synthesize scientific ideas into coherent explanations. In this study, we investigated how students constructed causal explanations of complex phenomena to better understand the ways they approach this practice. We interviewed 12 undergraduate science majors and asked them to explain real-world phenomena. From these interviews, we developed a characterization framework that described the reasoning patterns we found. In this framework, we identified three explanatory frames that differentiated the kinds of explanations students provided: a colloquial frame, wherein participants activated conceptual resources based on personal experience using everyday language; an emerging mechanistic frame, wherein participants used scientific concepts in semicoherent ways; and a causal mechanistic frame, wherein participants cohesively drew upon scientific conceptual resources to construct mechanistic explanations. Overall, the causal mechanistic frame was the least prevalent frame invoked by students. Instead, many drew on an emerging mechanistic frame and struggled to identify and apply scientific concepts to real-world scenarios. We advocate for incorporating opportunities to reason about real-world phenomena into undergraduate science curricula to provide students with experience integrating scientific concepts to explain real-world phenomena.

Vocal alignment to native and non-native speakers of English

Research on vocal alignment, the tendency for language users to match another individual's speech productions, suggests that multiple factors contribute to this behavior. Social and motivational goals, aspects of cognitive architecture, and linguistic flexibility may all affect the extent to which vocal alignment occurs, suggesting complex underlying mechanisms. The present study capitalized on the social and linguistic characteristics of Spanish-accented English to examine the relationship among these contributors to vocal alignment. American English-speaking adults participated in a shadowing task. Degree of vocal alignment was assessed by both acoustic measures and independent raters' judgments. Participants aligned to both native English and Spanish-accented productions, despite differences in attitudes to and intelligibility of the different accents. Individual differences in shadowers' vowel dispersion were also related to extent of vocal alignment, with greater dispersion associated with greater alignment. Acoustic measures were related to perceptual assessments of alignment and differed by accent type, suggesting that patterns of alignment may differ across accents. Overall, the current study demonstrates vocal alignment between talkers of differing language backgrounds and highlights the importance of acoustic and linguistic components of alignment behavior.

Physiotherapy pain curricula in Finland: a faculty survey

Background and aims

Despite the recognition of pain as a global health problem and advancements achieved in what is known about effective pain management, pain education for undergraduate health care professionals remains insufficient. This study investigated the content of pain curricula and the time allocated to pain education on physiotherapy programs at bachelor’s level at Universities of Applied Sciences (UASs) in Finland.

Methods

A web-based survey questionnaire was sent to the directors of the physiotherapy programs at all the Finnish UASs (n=15) where physiotherapy is taught at bachelor’s level. The questionnaire consisted of 14 questions covering basic concepts and the science of pain, pain assessment, pain management, and the adequacy of pain curricula. Each UAS completed one questionnaire i.e. returned one official opinion.

Results

The response rate was 80% (n=12). The mean for the total number of contact hours of pain education was 74 (standard deviation 34.2). All UASs had integrated pain education. In addition to this 42% (n=5) of the UASs had a separate pain course. The UASs offering such a course over and above the integrated pain education had twice the amount of pain content education compared to those UASs that only had integrated pain education (mean 103 h vs. 53 h, p=0.0043). Most of the education was devoted to conditions where pain is commonly a feature, manual therapy, and electrical agents for pain control. The biopsychosocial model of pain, cognitive behavioral methods of pain management, physician management, and multidisciplinary management were the least covered topics. Five UASs (42%) payed attention to the International Association for the Study of Pain curriculum outline and only 33% (n=4) considered their pain education to be sufficient.

Conclusions

Our results indicate that more contact hours are devoted to pain education on the Finnish UASs’ physiotherapy programs at bachelor’s level, than has previously been reported in faculty surveys. A separate pain course is one way to ensure a sufficient amount of pain education. Overall, despite a sufficient time devoted to pain education, some essential pain contents were inadequately covered.

Implications

The study contributes information on how pain education can be organized on physiotherapy programs at undergraduate level. Besides a sufficient amount of pain education, which can be ensured by a separate pain course, attention should be paid to pain education content being up-to-date. This could help in estimating the different proportions of pain content needed in educational settings. Efforts should also be made at keeping integrated pain education well-coordinated and purposeful. There is a need for further research estimating the effectiveness of pain education according to the different ways in which it is organized. There is also a need to investigate whether more hours allocated to pain education results in better understanding and professional skills.

Molecular Illustration in Research and Education: Past, Present, and Future

Two-dimensional illustration is used extensively to study and disseminate the results of structural molecular biology. Molecular graphics methods have been and continue to be developed to address the growing needs of the structural biology community, and there are currently many effective, turn-key methods for displaying and exploring molecular structure. Building on decades of experience in design, best-practice resources are available to guide creation of illustrations that are effective for research and education communities.

Economic complexities and cognitive hurdles: Accounting for specific economic misconceptions without an ultimate cause

Do folk-economic beliefs have an ultimate cause? We argue that, in many cases, the answer is negative. Cognition is constrained in both scope (via long-term memory [LTM]) and depth (via working memory [WM]). Consequently, laypeople are challenged by concepts essential for understanding complex systems, economics included: aggregation, indirect causation, and equilibrium. We discuss several economic misconceptions arising from this acute mismatch.

How Four Scientists Integrate Thermodynamic and Kinetic Theory, Context, Analogies, and Methods in Protein-Folding and Dynamics Research: Implications for Biochemistry Instruction

To keep biochemistry instruction current and relevant, it is crucial to expose students to cutting-edge scientific research and how experts reason about processes governed by thermodynamics and kinetics such as protein folding and dynamics. This study focuses on how experts explain their research into this topic with the intention of informing instruction. Previous research has modeled how expert biologists incorporate research methods, social or biological context, and analogies when they talk about their research on mechanisms. We used this model as a guiding framework to collect and analyze interview data from four experts. The similarities and differences that emerged from analysis indicate that all experts integrated theoretical knowledge with their research context, methods, and analogies when they explained how phenomena operate, in particular by mapping phenomena to mathematical models; they explored different processes depending on their explanatory aims, but readily transitioned between different perspectives and explanatory models; and they explained thermodynamic and kinetic concepts of relevance to protein folding in different ways that aligned with their particular research methods. We discuss how these findings have important implications for teaching and future educational research.

Sure, or unsure? Measuring students' confidence and the potential impact on patient safety in multiple-choice questions

BACKGROUND

Multiple-choice questions (MCQs) provide useful information about correct and incorrect answers, but they do not offer information about students' confidence.

METHODS

Ninety and another 81 medical students participated each in a curricular neurology multiple-choice exam and indicated their confidence for every single MCQ. Each MCQ had a defined level of potential clinical impact on patient safety (uncritical, risky, harmful). Our first objective was to detect informed (IF), guessed (GU), misinformed (MI), and uninformed (UI) answers. Further, we evaluated whether there were significant differences for confidence at correct and incorrect answers. Then, we explored if clinical impact had a significant influence on students' confidence.

RESULTS

There were 1818 IF, 635 GU, 71 MI, and 176 UI answers in exam I and 1453 IF, 613 GU, 92 MI, and 191 UI answers in exam II. Students' confidence was significantly higher for correct than for incorrect answers at both exams (p < 0.001). For exam I, students' confidence was significantly higher for incorrect harmful than for incorrect risky classified MCQs (p = 0.01). At exam II, students' confidence was significantly higher for incorrect harmful than for incorrect benign (p < 0.01) and significantly higher for correct benign than for correct harmful categorized MCQs (p = 0.01).

CONCLUSIONS

We were pleased to see that there were more informed than guessed, more uninformed than misinformed answers and higher students' confidence for correct than for incorrect answers. Our expectation that students state higher confidence in correct and harmful and lower confidence in incorrect and harmful MCQs could not be confirmed.

Structure-function relations in physiology education: Where's the mechanism?

Physiology demands systems thinking: reasoning within and between levels of biological organization and across different organ systems. Many physiological mechanisms explain how structures and their properties interact at one level of organization to produce emergent functions at a higher level of organization. Current physiology principles, such as structure-function relations, selectively neglect mechanisms by not mentioning this term explicitly. We explored how students characterized mechanisms and functions to shed light on how students make sense of these terms. Students characterized mechanisms as 1) processes that occur at levels of organization lower than that of functions; and 2) as detailed events with many steps involved. We also found that students produced more variability in how they characterized functions compared with mechanisms: students characterized functions in relation to multiple levels of organization and multiple definitions. We interpret these results as evidence that students see mechanisms as holding a more narrow definition than used in the biological sciences, and that students struggle to coordinate and distinguish mechanisms from functions due to cognitive processes germane to learning in many domains. We offer the instructional suggestion that we scaffold student learning by affording students opportunities to relate and also distinguish between these terms so central to understanding physiology.

Adolescents' and Young Adults' Naïve Understandings of the Economic Crisis

Over the last decade, Financial Literacy (FL) and interventions aimed at improving it, that is Financial Education (FE), have been the focus of increased attention from economists, governments, and international organizations such as the world Bank and OECD, but much less by scholars in the fields of Learning and Instruction. We examined open-ended written answers on the causes of the economic crisis that started in 2007-2008, as given by 381 Italian secondary school and university students, and 268 Swiss Italian-speaking secondary school students. Most Italian students mentioned internal political causes (i.e., corrupt politicians or inefficiency of the government), whereas Swiss students mentioned banks more often. International factors were rarely mentioned by either group, and explanations were generally very poor, listing a few causes without making connections between them. These findings indicate the need for economics education aimed at making people more knowledgeable of the workings of the economic system and the effects of financial systems on the real economy.

Spatial analogies pervade complex relational reasoning: Evidence from spontaneous gestures

How do people think about complex phenomena like the behavior of ecosystems? Here we hypothesize that people reason about such relational systems in part by creating spatial analogies, and we explore this possibility by examining spontaneous gestures. In two studies, participants read a written lesson describing positive and negative feedback systems and then explained the differences between them. Though the lesson was highly abstract and people were not instructed to gesture, people produced spatial gestures in abundance during their explanations. These gestures used space to represent simple abstract relations (e.g., increase) and sometimes more complex relational structures (e.g., negative feedback). Moreover, over the course of their explanations, participants' gestures often cohered into larger analogical models of relational structure. Importantly, the spatial ideas evident in the hands were largely unaccompanied by spatial words. Gesture thus suggests that spatial analogies are pervasive in complex relational reasoning, even when language does not.

Spatial analogies pervade complex relational reasoning: Evidence from spontaneous gestures

How do people think about complex phenomena like the behavior of ecosystems? Here we hypothesize that people reason about such relational systems in part by creating spatial analogies, and we explore this possibility by examining spontaneous gestures. In two studies, participants read a written lesson describing positive and negative feedback systems and then explained the differences between them. Though the lesson was highly abstract and people were not instructed to gesture, people produced spatial gestures in abundance during their explanations. These gestures used space to represent simple abstract relations (e.g., increase) and sometimes more complex relational structures (e.g., negative feedback). Moreover, over the course of their explanations, participants’ gestures often cohered into larger analogical models of relational structure. Importantly, the spatial ideas evident in the hands were largely unaccompanied by spatial words. Gesture thus suggests that spatial analogies are pervasive in complex relational reasoning, even when language does not.

Perspectives on culture and concepts

The well-respected tradition of research on concepts uses cross-cultural comparisons to explore which aspects of conceptual behavior are universal versus culturally variable. This work continues, but it is being supplemented by intensified efforts to study how conceptual systems and cultural systems interact to modify and support each other. For example, cultural studies within the framework of domain specificity (e.g., folkphysics, folkpsychology, folkbiology) are beginning to query the domains themselves and offer alternative organizing principles (e.g., folksociology, folkecology). Findings highlight the multifaceted nature of both concepts and culture: Individuals adopt distinct conceptual construals in accordance with culturally infused systems such as language and discourse, knowledge and beliefs, and epistemological orientations. This picture complicates questions about cognitive universality or variability, suggesting that researchers may productively adopt a systems-level approach to conceptual organization and cultural epistemologies. Related implications for diversity in cognitive science are discussed.

Does student confidence on multiple-choice question assessments provide useful information?

CONTEXT

Feedback from multiple-choice question (MCQ) assessments is typically limited to a percentage correct score, from which estimates of student competence are inferred. The students' confidence in their answers and the potential impact of incorrect answers on clinical care are seldom recorded. Our purpose was to evaluate student confidence in incorrect responses and to establish how confidence was influenced by the potential clinical impact of answers, question type and gender.

METHODS

This was an exploratory, cross-sectional study conducted using a convenience sample of 104 Year 3 dental students completing 20 MCQs on implant dentistry. Students were asked to select the most correct response and to indicate their confidence in it for each question. Identifying both correctness and confidence allowed the designation of uninformed (incorrect and not confident) or misinformed (incorrect but confident) responses. In addition to recording correct/incorrect responses and student confidence, faculty staff designated incorrect responses as benign, inappropriate or potentially harmful if applied to clinical care. Question type was identified as factual or complex. Logistic regression was used to evaluate relationships between student confidence, and question type and gender.

RESULTS

Students were misinformed more often than uninformed (22% versus 8%), and misinformed responses were more common with complex than factual questions (p < 0.05). Students were significantly more likely to be confident of correct than incorrect benign, incorrect inappropriate or incorrect harmful answers (p < 0.001), but, contrary to expectations, confidence did not decrease as answers became more harmful.

CONCLUSIONS

Recording student confidence was helpful in identifying uninformed versus misinformed responses, which may allow for targeted remediation strategies. Making errors of calibration (confidence and accuracy) more visible may be relevant in feedback for professional development.