Clinical Summary and Reasoning Format: Cognition Levels and Proposal of a Grading System

The Clinical Summary and Reasoning Format (CSRF) was designed by the Faculties of Paediatrics of the National Postgraduate Medical College of Nigeria and the West African College of Physicians. The form is recommended for routine use in clinical practice as well as for training and examination purposes. The form has sections for documenting information derived from interacting with an index patient and sections for documenting sequential deductions on the way to various levels of diagnosis. The levels of cognition required to complete different sections of the Clinical Summary and Reasoning Format (CSRF) vary in complexity. The CSRF is potentially useful for assessing the quality of a clinician's clinical reasoning process. Such assessment will be enhanced by having a grading system for completed CSRF forms. In turn, grading contents of the form should reflect complexity of the levels of cognition required for the various sections. The present paper evaluated the sections of the CSRF with reference to the modified Bloom's Taxonomy of cognition and also proposed a grading scheme for assessing CSRF forms completed by trainees.