REACT: Rapid Evaluation Assessment of Clinical Reasoning Tool

Area of Science:

• Medical Education
• Clinical Reasoning Assessment
• Simulation-Based Learning

Background:

• Clinical reasoning is crucial for diagnosis and management, especially in urgent care.
• Traditional assessment tools may be less effective in high-pressure, time-sensitive urgent clinical situations.
• Situated cognition theory highlights the impact of context on clinical reasoning.

Purpose of the Study:

• To develop and pilot a novel tool for assessing clinical reasoning in urgent care settings.
• To provide formative feedback to medical learners during simulated urgent clinical scenarios.
• To enhance the reliability and validity of clinical reasoning assessment in high-stakes situations.

Main Methods:

• The Rapid Evaluation Assessment of Clinical Reasoning Tool (REACT) was designed by a multidisciplinary team.
• REACT is a behaviorally anchored assessment tool focusing on five key domains.
• A pilot study involved fourth-year medical students in simulated urgent scenarios, scored by independent educators.

Main Results:

• The pilot study demonstrated strong internal consistency for REACT scores (Cronbach's alpha = 0.86).
• Inter-rater reliability for overall scores was found to be moderate (weighted kappa = 0.56).
• The tool was validated using two established frameworks.

Conclusions:

• REACT is the first tool specifically designed for formative assessment of clinical reasoning in simulated urgent situations.
• The tool shows evidence of reliability and content validity for guiding feedback.
• REACT aims to reduce diagnostic and management errors, ultimately limiting patient harm.