Assessment of Clinical Reasoning During a High Stakes Medical Student OSCE.

IF 4.8 2区 医学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES
Perspectives on Medical Education Pub Date : 2024-12-12 eCollection Date: 2024-01-01 DOI:10.5334/pme.1513
Jeffrey Siegelman, Lisa Bernstein, Jennifer Goedken, Linda Lewin, Jason Schneider, Martha Ward, Hugh Stoddard
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引用次数: 0

Abstract

Background & need for innovation: Objective Structured Clinical Examinations (OSCEs) are commonly employed to assess clinical skills. While several existing tools address components of clinical reasoning, including the Assessment of Reasoning Tool, none are calibrated for competency-based assessment of medical students (UME) in an OSCE setting.

Goal of innovation: We sought to create a clinical reasoning assessment for use in a high-stakes, summative medical student OSCE.

Steps taken for development and implementation of innovation: A minimum-competency OSCE was administered to medical students following their required clinical clerkships. We developed a tool to assess clinical reasoning of medical students at the conclusion of their required clinical clerkships and deployed it during a minimum-competency OSCE exam given at that time. The highest level of the modified tool represented minimum acceptable performance for examinees.

Evaluation of innovation: The scores and analyses provided evidence to support the use of this tool. Examinees' performance on clinical reasoning tasks was comparable with their overall performance on the OSCE. The sub-scores for clinical reasoning accurately distinguished successful examinees from those who did not meet the minimum performance level, providing support for the use of the tool in this high stakes setting.

Critical reflection: This tool was found to be useful and defensible to assess medical students' clinical reasoning. Expanded evidence for generalizability of the tool and its utility in other settings will need to be garnered through multi-center implementation and study.

在高风险的医学生 OSCE 考试中评估临床推理能力。
背景与创新需求:客观结构化临床考试(OSCE)通常用于评估临床技能。虽然现有的几种工具(包括推理评估工具)都涉及临床推理的组成部分,但没有一种工具是在 OSCE 环境中对医科学生(UME)进行能力评估时使用的:创新目标:我们试图创建一种临床推理评估方法,用于高风险、终结性的医学生 OSCE:在医学生完成规定的临床实习后,对其进行最低能力 OSCE。我们开发了一种工具,用于在医学生完成规定的临床实习后评估其临床推理能力,并在当时举行的最低能力 OSCE 考试中使用。修改后的工具的最高水平代表了考生的最低可接受成绩:评分和分析为这一工具的使用提供了证据。考生在临床推理任务上的表现与其在 OSCE 考试中的总体表现相当。临床推理的分项评分准确地区分了成功的考生和未达到最低成绩水平的考生,为在这种高风险环境中使用该工具提供了支持:批判性思考:这一工具在评估医学生临床推理能力方面是有用的,也是站得住脚的。该工具的推广性及其在其他环境中的实用性还需要通过多中心实施和研究来获得更多证据。
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来源期刊
CiteScore
5.70
自引率
8.30%
发文量
31
审稿时长
28 weeks
期刊介绍: Perspectives on Medical Education mission is support and enrich collaborative scholarship between education researchers and clinical educators, and to advance new knowledge regarding clinical education practices. Official journal of the The Netherlands Association of Medical Education (NVMO). Perspectives on Medical Education is a non-profit Open Access journal with no charges for authors to submit or publish an article, and the full text of all articles is freely available immediately upon publication, thanks to the sponsorship of The Netherlands Association for Medical Education. Perspectives on Medical Education is highly visible thanks to its unrestricted online access policy. Perspectives on Medical Education positions itself at the dynamic intersection of educational research and clinical education. While other journals in the health professional education domain orient predominantly to education researchers or to clinical educators, Perspectives positions itself at the collaborative interface between these perspectives. This unique positioning reflects the journal’s mission to support and enrich collaborative scholarship between education researchers and clinical educators, and to advance new knowledge regarding clinical education practices. Reflecting this mission, the journal both welcomes original research papers arising from scholarly collaborations among clinicians, teachers and researchers and papers providing resources to develop the community’s ability to conduct such collaborative research. The journal’s audience includes researchers and practitioners: researchers who wish to explore challenging questions of health professions education and clinical teachers who wish to both advance their practice and envision for themselves a collaborative role in scholarly educational innovation. This audience of researchers, clinicians and educators is both international and interdisciplinary. The journal has a long history. In 1982, the journal was founded by the Dutch Association for Medical Education, as a Dutch language journal (Netherlands Journal of Medical Education). As a Dutch journal it fuelled educational research and innovation in the Netherlands. It is one of the factors for the Dutch success in medical education. In 2012, it widened its scope, transforming into an international English language journal. The journal swiftly became international in all aspects: the readers, authors, reviewers and editorial board members. The editorial board members represent the different parental disciplines in the field of medical education, e.g. clinicians, social scientists, biomedical scientists, statisticians and linguists. Several of them are leading scholars. Three of the editors are in the top ten of most cited authors in the medical education field. Two editors were awarded the Karolinska Institute Prize for Research. Presently, Erik Driessen leads the journal as Editor in Chief. Perspectives on Medical Education is highly visible thanks to its unrestricted online access policy. It is sponsored by theThe Netherlands Association of Medical Education and offers free manuscript submission. Perspectives on Medical Education positions itself at the dynamic intersection of educational research and clinical education. While other journals in the health professional education domain orient predominantly to education researchers or to clinical educators, Perspectives positions itself at the collaborative interface between these perspectives. This unique positioning reflects the journal’s mission to support and enrich collaborative scholarship between education researchers and clinical educators, and to advance new knowledge regarding clinical education practices. Reflecting this mission, the journal both welcomes original research papers arising from scholarly collaborations among clinicians, teachers and researchers and papers providing resources to develop the community’s ability to conduct such collaborative research. The journal’s audience includes researchers and practitioners: researchers who wish to explore challenging questions of health professions education and clinical teachers who wish to both advance their practice and envision for themselves a collaborative role in scholarly educational innovation. This audience of researchers, clinicians and educators is both international and interdisciplinary. The journal has a long history. In 1982, the journal was founded by the Dutch Association for Medical Education, as a Dutch language journal (Netherlands Journal of Medical Education). As a Dutch journal it fuelled educational research and innovation in the Netherlands. It is one of the factors for the Dutch success in medical education. In 2012, it widened its scope, transforming into an international English language journal. The journal swiftly became international in all aspects: the readers, authors, reviewers and editorial board members. The editorial board members represent the different parental disciplines in the field of medical education, e.g. clinicians, social scientists, biomedical scientists, statisticians and linguists. Several of them are leading scholars. Three of the editors are in the top ten of most cited authors in the medical education field. Two editors were awarded the Karolinska Institute Prize for Research. Presently, Erik Driessen leads the journal as Editor in Chief. Perspectives on Medical Education is highly visible thanks to its unrestricted online access policy. It is sponsored by theThe Netherlands Association of Medical Education and offers free manuscript submission.
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