Clinical reasoning performance assessment: using situated cognition theory as a conceptual framework.

Area of Science:

• Medical Education
• Cognitive Science
• Assessment Science

Background:

• Assessing clinical reasoning performance presents significant challenges.
• Situated cognition theory offers a framework for understanding cognition within context.
• Understanding the interplay between clinicians and situational factors is crucial for effective assessment.

Purpose of the Study:

• To apply situated cognition theory to develop a conceptual model for assessing clinical reasoning.
• To elucidate the impact of contextual factors on clinical reasoning performance assessment outcomes.

Main Methods:

• Development of a conceptual model based on situated cognition theory.
• Identification and analysis of six key contextual factors: assessee, patient, rater, environment, assessment method, and task.
• Exploration of the interactions between these factors and their influence on assessment outcomes.

Main Results:

• The conceptual model highlights the complex interactions between contextual factors influencing clinical reasoning assessment.
• Six contextual factors identified: assessee, patient, rater, environment, assessment method, and task.
• Interactions among these factors significantly impact clinical reasoning performance assessment outcomes.

Conclusions:

• Valid clinical reasoning assessment necessitates broad sampling of learners by expert raters in diverse contexts.
• Explicit definition and exploration of contextual factors are essential for accurate assessment.
• Non-linear statistical models may be required to capture complex interactions in clinical reasoning assessment.