Attitudes of veterinary faculty to the assessment of clinical reasoning using extended matching questions

For assessment purposes, clinical expertise is often divided into three broad components: scientific and clinical knowledge, clinical reasoning, and practical/technical skills. This structure can be used to define the tools used for assessment of clinical students. Knowledge can be assessed through a variety of written formats and skills through various practical assessments, including the objective structured clinical examination (OSCE), but the assessment of clinical reasoning has proved to be far more challenging. A companion paper (Tomlin JL, Pead MJ, May SA. Veterinary students' attitudes toward the assessment of clinical reasoning using extended matching questions. J Vet Med Educ 35:612-621, 2008) reports on the identification and implementation of a valid and reliable method to assess clinical reasoning using clinical-scenario-based extended matching questions (EMQs) in the final examinations at the Royal Veterinary College and looks at students' response to the new examination format. Although EMQs were generally well accepted, many students were concerned about the implied encouragement of pattern recognition, a non-analytical form of clinical reasoning that results from recognition of familiar clinical situations. This paper addresses the attitudes of the teaching faculty to the EMQ format. The students' concerns about promotion of pattern recognition, was also explored in more depth. Overall, faculty perceived EMQs as an appropriate way to test clinical reasoning and as relevant to the experience that students would have gained during their clinical rotations. However, faculty felt that EMQs were difficult to write and that poorly written questions tended to promote pattern recognition. Almost half reiterated the students' concerns that pattern recognition may be an inappropriate reasoning strategy for undergraduates.