Documenting medical students' use of self-explanations: tool development and initial validity evidence

Area of Science:

• Medical Education
• Clinical Reasoning
• Learning Strategies

Background:

• Self-explanation (SE) is a learning strategy used to develop clinical reasoning skills in medical students.
• A validated tool is needed to document the appropriate use of SE and ensure its learning benefits.
• Existing curricula lack a standardized method for assessing SE application.

Purpose of the Study:

• To develop and validate a tool for documenting medical students' use of self-explanation.
• To provide evidence of the tool's validity in assessing SE application.

Main Methods:

• The tool was developed using DeVellis's eight-step process.
• Eighty-five audio-recorded self-explanations were assessed by three raters.
• Validity evidence was gathered through content analysis (inferences, case elements) and response process analysis (interrater agreement).

Main Results:

• Assessors documented a range of biomedical inferences (13.33–17.76), clinical inferences (16.27–27.04), monitoring statements (2.03–3.10), and case elements (21.77–26.87).
• Interrater reliability coefficients ranged from 0.53 to 0.96.
• The tool demonstrated consistency in assessor application and aligned with expected SE usage patterns.

Conclusions:

• A novel tool was successfully developed to document the application of self-explanation in medical education.
• The tool provides validity evidence for assessing SE in both educational and experimental settings.
• This instrument can help ensure the effective implementation of SE for enhancing clinical reasoning skills.