Complexity of Knowledge in Primary Care: Understanding the Discipline’s Requisite Knowledge—A Bibliometric Study

  • Frauke Dunkel
  • Martin Konitzer


Postgraduate examinations ought to reflect the knowledge base of a discipline (as described in textbooks, journals and scientific conferences), but do they? This project has been an attempt to understand family medicine’s requisite knowledge based on the content of two vocational examination samples between 2003 and 2005. The examination content was analysed bibliometrically.

The analysis showed a hierarchy of concordance between exam topics and the discipline’s knowledge domains of praxis, science and epidemiology, indicating that the exams fairly assess the candidates’ internalisation of the discipline’s practical knowledge.

In addition there is a “nested similarity” between the disciplines knowledge base, its exam catalogue and the corpora of its defining knowledge domains. Finding that the exam content has a high level of concordance with EBM guidelines and general practice epidemiology indicates that the exam rightly focuses on problems of daily care.

Future research has to explore if there is indeed a complex adaptive dynamic inherent in the postgraduate examination processes of German general practitioners.



We thank Joachim Sturmberg for thoroughly reading the manuscript and helpful comments, our MHH reviewers Marie-Louise Dierks and Carsten Kruschinski for their helpful suggestions for reworking this book chapter and Nils Schneider for his support of the research project. Last but not least, we thank Rita Borkowski, exams office of the Medical Board of Lower Saxony, for her continuous institutional support.


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Praxis Drs SiekerThaleGermany
  2. 2.Academic Teaching Practice, Medizinische Hochschule HannoverSchwarmstedtGermany

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