Threshold concepts and troublesome knowledge in the first year curriculum at a UK medical school [Poster]

Meek, S. and Jamieson, S. (2014) Threshold concepts and troublesome knowledge in the first year curriculum at a UK medical school [Poster]. In: O'Mahoney, C., Buchanan, A., O'Rourke, M. and Higgs, B. (eds.) Threshold Concepts: from Personal Practice to Communities of Practice: Proceedings of the National Academy’s Sixth Annual Conference and the Fourth Biennial Threshold Concepts Conference. NAIRTL. ISBN 9781906642594

Full text not currently available from Enlighten.


Medical education integrates multiple academic disciplines and professional training. Several Threshold Concepts (TCs) have been proposed in bioscience and nursing that are likely also relevant in medical education. These include probability and uncertainty; scale; hypothesis creation; care; and professional identity. In this study, we set out to identify troublesome areas and potential TCs in the medical curriculum at Glasgow University. As a first step, we designed questions to probe, directly and indirectly, staff perceptions about which areas of the current curriculum are particularly troublesome for first year medical students. First year is often a time of personal, academic and social transition, and transition is a defining TC characteristic. The Glasgow Year 1 curriculum includes both professional and discipline-specific topics (clinical and vocational skills; basic biomedical, social and psychological sciences), allowing exploration of TCs in multiple areas. Experts, learners or both may define TCs, so data from both is important. To date, we have examined staff perceptions and student exam performance. Semi-structured interviews with key teaching staff (n=4/8), and questionnaire responses from endof-year exam markers (n=11/23), were analysed qualitatively using the Miles and Huberman approach to analytic induction. Our results suggest that several previously-identified areas of troublesome knowledge (TKs) are also troublesome in Year 1 Medicine. We describe how these TKs map to previously-proposed TCs, including scale, dynamics (spatial and temporal), integration and link-making, equilibrium, metalearning, and discipline-based ways of organising and using knowledge. Additional TK areas were also identified, e.g. systems-based approaches to discipline integration, and specific skills. We discuss whether these indicate novel TCs. Many of the areas identified here are central to non-judgemental, patient-centred practice, which is a GMC requirement in training and professional development. Finally, we summarise teaching and assessment practices described by participants as enhancing TK/TC learning. The limitations and generalisability of this study are discussed.

Item Type:Book Sections
Glasgow Author(s) Enlighten ID:Meek, Dr Sarah and Jamieson, Professor Susan
Authors: Meek, S., and Jamieson, S.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Copyright Holders:Copyright © 2014 The Authors
First Published:First published in Threshold Concepts: from Personal Practice to Communities of Practice
Publisher Policy:Reproduced under a Creative Commons License
Related URLs:

University Staff: Request a correction | Enlighten Editors: Update this record