A developmental approach to evaluating competence in clinical reasoning

Area of Science:

• Medical Education
• Competency Assessment
• Clinical Reasoning Development

Background:

• Growing global emphasis on objective and accountable trainee evaluation in medical education.
• Clinical reasoning is a core competency in medical training, essential for transitioning from novice to expert.
• Understanding human medical education research can inform veterinary medical educators.

Purpose of the Study:

• To review the current state of clinical reasoning competency assessment in medical education.
• To explore the development of clinical reasoning from novice to expert.
• To provide insights for veterinary educators by examining human medical education practices.

Main Methods:

• Review of existing medical education research on clinical reasoning development.
• Identification and description of common stage-related learner difficulties (reduced knowledge, dispersed knowledge, tunnel vision, outsider).
• Discussion of specific measurement approaches for different developmental levels.

Main Results:

• Four common difficulties in clinical reasoning development are identified.
• Developmental approaches to assessing clinical reasoning competence are recommended.
• The RIME (reporter, interpreter, manager, expert) system and Script Concordance Test (SCT) are presented as evaluation examples.

Conclusions:

• Assessment of clinical reasoning competence requires a developmental approach.
• Specific evaluation methods like RIME and SCT can measure competence at different expertise levels.
• This review offers valuable perspectives for enhancing clinical reasoning assessment in veterinary education.