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Assessing Diagnostic Reasoning Using a Standardized Case-Based Discussion.

Ruth M Sutherland1, Katharine J Reid1, Neville G Chiavaroli1

  • 1Department of Medical Education, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia.

Journal of Medical Education and Curricular Development
|June 18, 2019
PubMed
Summary
This summary is machine-generated.

A new Standardized Case-Based Discussion (SCBD) offers a reliable method for assessing medical students' diagnostic reasoning (DR). This interactive oral assessment is feasible, acceptable, and provides unique insights into DR skills.

Keywords:
Standardized Case-Based Discussionclinical reasoningdiagnostic reasoningmedical educationoral assessment

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Area of Science:

  • Medical Education
  • Clinical Assessment
  • Diagnostic Reasoning

Background:

  • Assessing diagnostic reasoning (DR) in medical students is crucial but challenging.
  • Traditional written assessments lack dynamic evaluation, while oral formats face standardization issues.
  • There is a need for reliable and standardized methods to evaluate medical students' DR.

Purpose of the Study:

  • To develop and trial a Standardized Case-Based Discussion (SCBD) as a novel oral assessment tool.
  • To evaluate the feasibility, acceptability, and psychometric properties of the SCBD.
  • To determine if SCBD provides unique insights into diagnostic reasoning.

Main Methods:

  • Two cohorts of medical students (n=319, n=342) participated in the SCBD.
  • Students discussed their DR with an examiner for 15 minutes after watching a video trigger.
  • Examiner training and student/examiner perceptions were used to evaluate the assessment over two years.

Main Results:

  • The SCBD was feasible for large cohorts and acceptable to students and examiners.
  • Most participants agreed SCBD provided useful information on diagnostic reasoning.
  • The assessment demonstrated acceptable internal consistency and measured a related, novel construct.

Conclusions:

  • Standardized oral assessments like SCBD are valuable for initial medical training.
  • SCBD offers unique opportunities to explore diagnostic reasoning not found in other formats.
  • SCBD will be incorporated into clinical assessments, with further exploration of examiner approaches planned.