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Promoting Longitudinal and Developmental Computer-Based Assessments of Clinical Reasoning: Validity Evidence for a

Dario M Torre¹, Silvia Mamede², Teresa Bernardes³

¹D.M. Torre is director, Programs of Assessment, and professor of medicine, University of Central Florida College of Medicine, Orlando, Florida.

Academic Medicine : Journal of the Association of American Medical Colleges

|January 24, 2024

Summary

This summary is machine-generated.

This study validated the Clinical Reasoning Mapping Exercise (CResME) for assessing health profession students' clinical reasoning skills. The CResME shows promise in evaluating learners and supporting their development.

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Area of Science:

Medical Education
Health Professions Education
Clinical Reasoning Assessment

Background:

Assessing clinical reasoning is crucial but challenging for health professions.
Tools for evaluating clinical reasoning outside the workplace are scarce.
This study addresses the need for valid assessment methods.

Purpose of the Study:

To examine validity evidence for a novel Clinical Reasoning Mapping Exercise (CResME).
To evaluate the CResME's potential for assessing clinical reasoning in a non-workplace setting.

Main Methods:

The study involved 120 third-year medical students using the CResME across 3 topics.
Physician raters scored CResME performance using a rubric.
Validity evidence was gathered for response process, internal structure, and relations to other variables.

Main Results:

The CResME demonstrated good internal consistency reliability (Cronbach α 0.75–0.91).
The tool differentiated between high and low clinical reasoning skills.
Moderate correlations were found between CResME scores and objective structured clinical examination (OSCE) patient encounter notes and subject exam scores.

Conclusions:

The CResME is a viable tool for assessing clinical reasoning and supporting learner development.
Further research is needed to establish validity across diverse learners and settings.