A developmental assessment of clinical reasoning in preclinical medical education
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 desi...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2019-01-01
|
| Series: | Medical Education Online |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/10872981.2019.1591257 |
| _version_ | 1811261859866607616 |
|---|---|
| author | Alice A. Min Simpkins Bryna Koch Karen Spear-Ellinwood Paul St. John |
| author_facet | Alice A. Min Simpkins Bryna Koch Karen Spear-Ellinwood Paul St. John |
| author_sort | Alice A. Min Simpkins |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-12T19:13:27Z |
| format | Article |
| id | doaj.art-487e632bbe034d3daa7b597afac96fbf |
| institution | Directory Open Access Journal |
| issn | 1087-2981 |
| language | English |
| last_indexed | 2024-04-12T19:13:27Z |
| publishDate | 2019-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Medical Education Online |
| spelling | doaj.art-487e632bbe034d3daa7b597afac96fbf2022-12-22T03:19:48ZengTaylor & Francis GroupMedical Education Online1087-29812019-01-0124110.1080/10872981.2019.15912571591257A developmental assessment of clinical reasoning in preclinical medical educationAlice A. Min Simpkins0Bryna Koch1Karen Spear-Ellinwood2Paul St. John3University of ArizonaUniversity of Arizona College of Public HealthUniversity of ArizonaUniversity of ArizonaBackground: 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.http://dx.doi.org/10.1080/10872981.2019.1591257clinical reasoningmedical educationassessment |
| spellingShingle | Alice A. Min Simpkins Bryna Koch Karen Spear-Ellinwood Paul St. John A developmental assessment of clinical reasoning in preclinical medical education Medical Education Online clinical reasoning medical education assessment |
| title | A developmental assessment of clinical reasoning in preclinical medical education |
| title_full | A developmental assessment of clinical reasoning in preclinical medical education |
| title_fullStr | A developmental assessment of clinical reasoning in preclinical medical education |
| title_full_unstemmed | A developmental assessment of clinical reasoning in preclinical medical education |
| title_short | A developmental assessment of clinical reasoning in preclinical medical education |
| title_sort | developmental assessment of clinical reasoning in preclinical medical education |
| topic | clinical reasoning medical education assessment |
| url | http://dx.doi.org/10.1080/10872981.2019.1591257 |
| work_keys_str_mv | AT aliceaminsimpkins adevelopmentalassessmentofclinicalreasoninginpreclinicalmedicaleducation AT brynakoch adevelopmentalassessmentofclinicalreasoninginpreclinicalmedicaleducation AT karenspearellinwood adevelopmentalassessmentofclinicalreasoninginpreclinicalmedicaleducation AT paulstjohn adevelopmentalassessmentofclinicalreasoninginpreclinicalmedicaleducation AT aliceaminsimpkins developmentalassessmentofclinicalreasoninginpreclinicalmedicaleducation AT brynakoch developmentalassessmentofclinicalreasoninginpreclinicalmedicaleducation AT karenspearellinwood developmentalassessmentofclinicalreasoninginpreclinicalmedicaleducation AT paulstjohn developmentalassessmentofclinicalreasoninginpreclinicalmedicaleducation |