Educators’ epistemological experience of facilitating medical students’ active learning is under-researched, especially concerning non-biomedical learning in integrated curricula. Longitudinal, qualitative research on problem-based learning (PBL) tutors’ long-term insights is rare. Therefore, this study explores the following question: How do tutors conceptualise knowledge and knowing, particularly non-biomedical, after substantial experience in an integrated, problem-based medical curriculum and how does that relate to the student perspective? In a mixed-method study (pragmatism paradigm), sixteen years after semi-structured interviews with inaugural PBL tutors, follow-up interviews with the remaining ten revisited their replies about the population health knowledge theme. Via e-questionnaire, two years later, 9/10 tutors discussed student comments about their own knowledge base from four historical surveys (two student-cohorts, Years 1 and 5). Those surveys also provided a backdrop of comments on the public health knowledge theme, including threshold concepts and reducing health inequalities, plus Moore’s Cognitive Complexity Index (CCI). Each survey found mean CCI in Perry position 3–4 transition (multiplicity-to-relativism). Uncertainty or concern, especially about feared basic science gaps, prevailed across CCI scores. Public health knowledge appeared ‘worthy’ but unappealing for students’ professional identity, but tutors now appreciated its ‘ways of knowing’ and were more reflective, flexible, and accommodating about their own and students’ knowledge. Persistent challenges were student uncertainty or concern about knowledge gaps, particularly basic science, and conflict between knowledge types, for which staff and student epistemological support should be explicitly anticipated. Further research should explore staff–student epistemologies about other types of knowledge.
Gillian Maudsley (Fri,) studied this question.