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Do short cases elicit different thinking processes than factual knowledge questions do?

L W Schuwirth1, M M Verheggen, C P van der Vleuten

  • 1Department of Educational Development and Research, University of Maastricht, The Netherlands.

Medical Education
|April 25, 2001
PubMed
Summary

Case-based questions reveal deeper problem-solving thinking than factual knowledge questions. This study compared how general practitioners and students processed different question types, finding cases better reflect complex cognitive skills.

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Area of Science:

  • Cognitive Science
  • Medical Education
  • Psychology

Background:

  • Assessing medical professionals' cognitive processes is crucial for effective training and practice.
  • Differentiating between factual recall and complex problem-solving is a key challenge in educational assessment.

Purpose of the Study:

  • To investigate whether case-based questions stimulate different cognitive processes compared to factual knowledge-based questions.
  • To evaluate the nature of thinking elicited by various question formats in medical education.

Main Methods:

  • Twenty general practitioners (GPs) and 20 students engaged in thinking-aloud protocols while answering case-based and factual knowledge questions.
  • Verbatim transcripts were analyzed using five defined indicators: protocol length, immediate responses, information re-reading patterns, and consideration types ('true-false' vs. 'vector').

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Main Results:

  • Case-based questions generated longer thinking protocols and more 'vector' considerations (deliberative, directional thinking) compared to factual questions.
  • Students re-read more information than GPs, who provided more immediate responses and re-ordered case information differently.
  • Factual questions primarily elicited 'true-false' considerations, while cases prompted more complex, multi-faceted 'vector' considerations.

Conclusions:

  • Short case-based questions are more effective in assessing problem-solving abilities than factual knowledge questions.
  • The thinking processes evoked by case-based scenarios better represent the cognitive demands of clinical problem-solving.