TY - JOUR
T1 - A developmental assessment of clinical reasoning in preclinical medical education
AU - Min Simpkins, Alice A.
AU - Koch, Bryna
AU - Spear-Ellinwood, Karen
AU - St. John, Paul
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: Clinical reasoning is an essential skill to be learned during medical education. A developmental framework for the assessment and measurement of this skill has not yet been described in the literature. Objective: The authors describe the creation and pilot implementation of a rubric designed to assess the development of clinical reasoning skills in pre-clinical medical education. Design: The multi-disciplinary course team used Backwards Design to develop course goals, objectives, and assessment for a new Clinical Reasoning Course. The team focused on behaviors that students were expected to demonstrate, identifying each as a ‘desired result’ element and aligning these with three levels of performance: emerging, acquiring, and mastering. Results: The first draft of the rubric was reviewed and piloted by faculty using sample student entries; this provided feedback on ease of use and appropriateness. After the first semester, the course team evaluated whether the rubric distinguished between different levels of student performance in each competency. A systematic approach based on descriptive analysis of mid- and end of semester assessments of student performance revealed that from mid- to end-of-semester, over half the students received higher competency scores at semester end. Conclusion: The assessment rubric allowed students in the early stages of clinical reasoning development to understand their trajectory and provided faculty a framework from which to give meaningful feedback. The multi-disciplinary background of the course team supported a systematic and robust course and assessment design process. The authors strongly encourage other colleges to support the use of collaborative and multi-disciplinary course teams.
AB - Background: Clinical reasoning is an essential skill to be learned during medical education. A developmental framework for the assessment and measurement of this skill has not yet been described in the literature. Objective: The authors describe the creation and pilot implementation of a rubric designed to assess the development of clinical reasoning skills in pre-clinical medical education. Design: The multi-disciplinary course team used Backwards Design to develop course goals, objectives, and assessment for a new Clinical Reasoning Course. The team focused on behaviors that students were expected to demonstrate, identifying each as a ‘desired result’ element and aligning these with three levels of performance: emerging, acquiring, and mastering. Results: The first draft of the rubric was reviewed and piloted by faculty using sample student entries; this provided feedback on ease of use and appropriateness. After the first semester, the course team evaluated whether the rubric distinguished between different levels of student performance in each competency. A systematic approach based on descriptive analysis of mid- and end of semester assessments of student performance revealed that from mid- to end-of-semester, over half the students received higher competency scores at semester end. Conclusion: The assessment rubric allowed students in the early stages of clinical reasoning development to understand their trajectory and provided faculty a framework from which to give meaningful feedback. The multi-disciplinary background of the course team supported a systematic and robust course and assessment design process. The authors strongly encourage other colleges to support the use of collaborative and multi-disciplinary course teams.
KW - Clinical reasoning
KW - assessment
KW - medical education
UR - http://www.scopus.com/inward/record.url?scp=85063723936&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063723936&partnerID=8YFLogxK
U2 - 10.1080/10872981.2019.1591257
DO - 10.1080/10872981.2019.1591257
M3 - Article
C2 - 30935299
AN - SCOPUS:85063723936
VL - 24
JO - Medical Education Online
JF - Medical Education Online
SN - 1087-2981
IS - 1
M1 - 1591257
ER -