Abstract
The paper evaluates the importance of conceptions underlying practices in medicine and in medical education. It uses a study of anaesthetists’ approaches to practice, and of lectures in problem‐based learning, to illustrate the influence of a conception of ‘applying knowledge in, or to, practice’ and of its apparently serious limitations reflected in practice. A brief background to the pervasiveness of the conception is given, together with discussion of an alternative, and arguably better, conception and its realization in rigorous problem‐based learning in contrast to transitional, semi‐problem‐based learning.