Comparing Diagnostic Performance and the Utility of Clinical Vignette-Based Assessment Under Testing Conditions Designed to Encourage Either Automatic or Analytic Thought

Ilgen, Jonathan S.; Bowen, Judith L.; McIntyre, L; Banh, Kenny; Barnes, David; Coates, Wendy C.; Druck, Jeffrey; Fix, Megan L.; Rimple, Diane; Yarris, Lalena M.; Eva, Kevin W.

doi:10.1097/acm.0b013e3182a31c1e

Cited by 57 publications

(49 citation statements)

References 31 publications

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“…Our research supports previous literature that shows the importance of instructing EM clerkship students how to approach case of emergent patient (Ilgen, Bowen, McIntyre et al, 2013). Case conferences are resource-intensive in terms of creation of materials and faculty instructor time, but our study suggests that the benefits are worth the investment.…”

Section: Discussionsupporting

confidence: 77%

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Study on the Application of Case Teaching Method in the Cultivation of Master of Professional Clinical Surgery

Zheng¹,

Li²,

Wu³

et al. 2018

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Section: Discussionsupporting

confidence: 77%

“…This setting also provides novice learners deliberate access to the thought process of a seasoned clinician expert. In a study by Ilgen et al, novices and experts approached clinical scenarios using different strategies (Ilgen, Bowen, McIntyre et al, 2013). …”

Section: Implementation Methods Of Case Teachingmentioning

confidence: 99%

Study on the Application of Case Teaching Method in the Cultivation of Master of Professional Clinical Surgery

Zheng¹,

Li²,

Wu³

et al. 2018

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“…Subsequent research has compared self-chosen and instructed diagnostic reasoning strategies on specific clinical vignette MCQs to success on those same items, 3,[5][6][7] and evaluated the influence of test question format on predominant reasoning strategy. 8 However, although recent years have seen extensive evaluation and modification of clinical vignette MCQs, 9 no current studies have evaluated what trainees do when approaching such questions; nor have they assessed test-taking (TT) behaviors, or ''test-wiseness.''…”

Section: Introductionmentioning

confidence: 99%

“…20,32 Although think-aloud methodology is recognized as a means to capture thought processes, 17 it does not capture all thinking, particularly nonanalytic reasoning. 21 Additionally, USMLE scores may disproportionately reflect quick nonanalytic reasoning, 7 which was not encouraged by this study protocol. Participants' behavior may also have been influenced by the Hawthorne effect (ie, impact of being studied on participant behavior).…”

mentioning

confidence: 99%

Exploring Clinical Reasoning Strategies and Test-Taking Behaviors During Clinical Vignette Style Multiple-Choice Examinations: A Mixed Methods Study

Heist¹,

Gonzalo²,

Durning³

et al. 2014

Journal of Graduate Medical Education

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Background Clinical vignette multiple-choice questions (MCQs) are widely used in medical education, but clinical reasoning (CR) strategies employed when approaching these questions have not been well described. Objectives The aims of the study were (1) to identify CR strategies and test-taking (TT) behaviors of physician trainees while solving clinical vignette MCQs; and (2) to examine the relationships between CR strategies and behaviors, and performance on a high-stakes clinical vignette MCQ examination. Methods Thirteen postgraduate year–1 level trainees completed 6 clinical vignette MCQs using a think-aloud protocol. Thematic analysis employing elements of grounded theory was performed on data transcriptions to identify CR strategies and TT behaviors. Participants' CR strategies and TT behaviors were then compared with their US Medical Licensing Examination Step 2 Clinical Knowledge scores. Results Twelve CR strategies and TT behaviors were identified. Individuals with low performance on Step 2 Clinical Knowledge demonstrated increased premature closure and increased faulty knowledge, and showed comparatively less ruling out of alternatives or admission of knowledge deficits. High performers on Step 2 Clinical Knowledge demonstrated increased ruling out of alternatives and admission of knowledge deficits, and less premature closure, faulty knowledge, or closure prior to reading the alternatives. Conclusions Different patterns of CR strategies and TT behaviors may be used by high and low performers during high-stakes clinical vignette MCQ examinations.

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Section: Discussionmentioning

confidence: 99%

Dual Learning in an Emergency Medicine Clerkship Improves Student Performance

Jordan

Elder

Uijtdehaage

et al. 2016

The Journal of Emergency Medicine

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, Abstract-Background: The emergency department (ED) is an ideal environment to teach learners about the ''undifferentiated patient.'' Student learning may be inconsistent because of inherent variability in the ED. Previous research has suggested that standardizing the emergency medicine (EM) clerkship by implementing didactics and requiring students to see patients with particular chief complaints improves educational outcomes. Objective: To compare knowledge acquisition after a new curriculum to the traditional curriculum. Methods: This was a prospective, quasiexperimental study of senior medical students in an EM clerkship. Students were assigned to the dual learning (DL) group or standard learning (SL) groups based on month of rotation. All were required to see patients with 10 specific chief complaints and were lent an EM textbook. The SL group was instructed to read about the required cases. The DL group attended a 2-hour didactic session covering 5 of the 10 required cases. All students completed an identical pre-and postclerkship multiple choice knowledge test. Results: Data from 51 medical students (DL = 27; SL = 24) were analyzed. Mean pretest scores were comparable between groups. A 2 (groups) by 2 (sessions) mixed-design analysis of variance yielded a significant group by session interaction effect (p < 0.001). The DL group significantly increased its mean score from 8.

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Comparing Diagnostic Performance and the Utility of Clinical Vignette-Based Assessment Under Testing Conditions Designed to Encourage Either Automatic or Analytic Thought

Abstract: Instructions to trust one's first impres-sions result in similar performance when compared with instructions to consider clinical information in a systematic fashion, but have greater utility when used for the purposes of assessment.

Cited by 57 publications

References 31 publications

Study on the Application of Case Teaching Method in the Cultivation of Master of Professional Clinical Surgery

Study on the Application of Case Teaching Method in the Cultivation of Master of Professional Clinical Surgery

Exploring Clinical Reasoning Strategies and Test-Taking Behaviors During Clinical Vignette Style Multiple-Choice Examinations: A Mixed Methods Study

Dual Learning in an Emergency Medicine Clerkship Improves Student Performance

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