The Difference Between Theory, Theoretical, and Conceptual Frameworks

The terms "theory," "theoretical framework," and "conceptual framework" are often used interchangeably, yet they have different meanings depending on who you ask.

In medical education research, these terms play a critical role in research and scholarly discussions.

There are generally two schools of thought regarding these terms:

1. The Lumpers: This camp, which created by Dr. Georges Bordage, believes that all these terms can be encompassed within the idea of "conceptual frameworks." Bordage's approach refrains from making clear distinctions between these terms.
2. The Splitters: This camp, represented by scholars like Varpio et al., put forward distinct definitions for each term and how they contribute differently to research and problem-solving.

Both camps agree on one thing: the significance of having an organizing principle in the realm of medical education research.

This lesson will dive into these two perspectives, explore their implications, and offer guidance on which approach might be best suited for you, depending on your level of expertise in medical education research.

Dr. Georges Bordage authored a seminal paper titled "Conceptual Frameworks to Illuminate and Magnify." In this paper, he avoids making a sharp distinction between theory, theoretical framework, and conceptual framework.

In Bordage's view, everything falls into the bucket of "conceptual frameworks." According to his paper, these frameworks serve two primary functions: they act as "lighthouses and lenses."

Dr. Bordage uses vivid metaphors to describe conceptual frameworks. He likens them to lighthouses that illuminate specific parts of the academic "ocean," highlighting certain issues while leaving others in the dark.

Similarly, conceptual frameworks also act like magnifying glasses, zeroing in on specific elements of a research question or problem. (See Why Your Medical Education Research Needs Theory)

At MedEdMENTOR, we find Bordage's metaphors so compelling that they inspired our logo—a telescope, representing a series of lenses aimed at helping you navigate the universe of medical education.

If you're a beginner in medical education research, Bordage's approach provides a simplified, unified way to structure your academic inquiries. (However, note that we are actually Splitters here, since we have a Theory Database, not a "Conceptual Frameworks Database")

Welcome to the camp of the "Splitters," the group of scholars and educators who seek to differentiate between theory, theoretical framework, and conceptual framework. This camp aims to provide more nuanced tools for the design and interpretation of research in medical education.

In the paper "The Distinctions Between Theory, Theoretical Framework, and Conceptual Framework," Varpio et al. have set what is currently considered the gold standard for understanding these differences. This work is highly revered at MedEdMENTOR, and we recommend it as essential reading for anyone deeply involved in medical education research.

Varpio and colleagues offer clear definitions for each term:

• Theory: An abstract set of interrelated ideas and concepts that help to organize the complexities of our reality. (e.g. Theory Database)
• Theoretical Framework: The application of that abstract mental model (i.e., theory) to a real-world problem. It is what happens when you "map" a theory onto a specific research question or phenomenon.
• Conceptual Framework: This is the rationale for applying a particular theory to a particular problem. It provides the argument, backed by literature review and methodology, to persuade an audience that the chosen approach is sound.

We won't speak for everyone, but generally the "Splitters" believe that by distinguishing between these elements, you can achieve greater clarity in your research endeavors. This enables not just rigorous analysis but also enhances the communicative power of your work, making it easier for peers to engage with and build upon it.

Despite differences in their approaches to delineating theory, theoretical framework, and conceptual framework, both the "Lumpers" and "Splitters" agree on one crucial point: the importance of having some form of organizing principle in your research.

In the complex field of medical education, a set of organizing principles is indispensable for two main reasons:

1. Complexity of research problems: The issues addressed in medical education research are complex, necessitating a structure to ensure that research intentions are well-organized and reasonable.
2. Clear communication: These principles, whether you call them theories or frameworks, help scholars communicate more clearly, allowing for the construction of a communal body of literature that advances the field.

If you are new to medical education research, it might be best to start by aligning with the "Lumpers." At this stage, it may be more practical to refer to everything as a conceptual framework as you get your footing.

For those who are more comfortable with these terms and have some experience in medical education research, revisiting this topic with the distinctions offered by the "Splitters," can add nuanced understanding and precision to your work.

(At MedEdMENTOR we're splitters, which is why we have a Theory Database and not a "Conceptual Frameworks Database.")

If you have a research mentor, don't hesitate to consult them on this matter. They can provide valuable insights based on their own experience and the prevailing views in your specific research community.

Let's consider a real-world example to better understand how these terms—theory, theoretical framework, and conceptual framework—come into play during the research process.

Suppose an internal medicine clerkship director wants to improve medical students' oral presentation skills. Identifying a clear problem or issue is the starting point for any research endeavor.

Before diving into possible solutions, our clerkship director consults existing theories to guide her approach. She turns to MedEdMENTOR and finds a list of theories that might be relevant. As she reads the summaries of the various frameworks, she found many that might be applicable, including:

• 3-P Model
• 4-Component Instructional Design Model
• Cognitive Load Theory
• ADDIE Model
• Kern's Model of Curriculum Development
• Bloom's Taxonomy
• Andragogy
• Deliberate Practice Theory
• Dreyfus (Five-Stage) Model of Skill Acquisition
• Joplin’s Five-Stage Model of Experiential Learning
• Communities of practice
• Mastery Learning
• Miller’s Pyramid of Skill Development
• R2C2 Feedback Model
• Zone of Proximal Development

She found a few that she found most appealing and dove deeper into reading about them from the resources she found on their theory pages.

After some reading and consideration, the director designed the following curriculum:

• A peer-to-peer teaching and learning model built upon the concepts of Communities of practice, Andragogy, and Peer Assessment.
• The learners are given the basic structure of a group that is tasked with raising the skill level of every member. They are expected to set their own group and individual goals, support one another, and give each other meaningful feedback.
• To assist with setting goals and making meaningful progress, the learners are introduced to the concepts of Deliberate Practice Theory and Dreyfus (Five-Stage) Model of Skill Acquisition.
• Along with the explanation of the Drefyus Model, students are also provided with a clinical case as well as video examples of oral presentations based on the clinical case representing the 5 different stages of skill level (novice, advanced beginner, competent, proficient, and expert).

This is her theoretical framework—applying theories to a real-world problem.

To justify her approach, the director crafts her conceptual framework—the argument for why her chosen theoretical framework is both relevant and effective. Her rationale:

• She chose Communities of practice, Andragogy, and Peer Assessment because she finds that students learn very well from one another, and they seem to be much more motivated when they are setting their own goals and working towards something they care about. The papers she read on these topics supported these ideas.
• She chose Deliberate Practice Theory and Dreyfus (Five-Stage) Model of Skill Acquisition because these two models seemed particularly relevant to help provide these students with scaffolding to approach their work with intent. The deliberate practice theory seemed appropriate to help the students break down the tasks into pieces and focus on specific goals as opposed to blind repetition of tasks. The Dreyfus Model and the video examples provide tangible targets that learners can use to benchmark their learning objectives.

With a well-defined problem, theory, theoretical framework, and conceptual framework, our clerkship director is ready to begin her research.

Learners are told they will not be evaluated based on any of their work in these groups, however, they are asked if they are willing to have their group work videotaped and analyzed to see if the theories that were employed to create this curricular approach are apparent in practice. She begins her research project.

Our example highlights how systematically applying theories, theoretical frameworks, and conceptual frameworks to your educational interventions elevates them into scholarly activities.

While educational techniques are important, the depth provided by a solid theoretical and conceptual grounding ensures the research has both methodological rigor and conceptual depth.

By adhering to these principles, the internal medicine clerkship director succeeded in transforming what could have been a simple intervention into a scholarly project that contributes to the medical education literature.

When it comes to choosing between lumping all organizing principles into the bucket of conceptual frameworks (Bordage approach) or making clear distinctions between theory, theoretical framework, and conceptual framework (Varpio et al), there is no one-size-fits-all answer.

If you're new to this field, or even if you're a seasoned researcher, it might be useful to consult a research mentor or colleagues to gain more perspectives. MedEdMENTOR encourages dialogue and learning from one another in this evolving field.

As you gain more experience and familiarity with educational theory, you may find yourself transitioning from one camp to the other. For beginners, sticking to calling everything a conceptual framework might be a good starting point, but as you grow, making these distinctions can add depth and specificity to your research.