The role of scientific knowledge in understanding practical problems is controversial. This paper deals with a specific issue of students’ understanding of basic science in the explanation of a medical problem. The study examines first‐year medical students’ explanations of complex concepts in cardio‐pulmonary physiology following a lecture series. Using an essay question, the students’ responses were evaluated for the relevant information used and for the accuracy and completeness with which inferences about causality were generated. The results revealed systematic misconceptions by the students in developing a pathophysiological model of the problem; these ranged from an inability to conceptualize the cardio‐pulmonary system as a closed system, to exhibiting difficulty in relating across different levels of granularity: Cellular to organ to patient. The implications for science instruction within a medical curriculum are discussed.
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