Electronic assessment of clinical reasoning in clerkships: A mixed-methods comparison of long-menu key-feature problems with context-rich single best answer questions

Huwendiek, Sören; Reichert, Friedrich; Duncker, Cecilia; Leng, Bas A. de; Vleuten, Cees van der; Muijtjens, Arno M. M.; Bosse, Hans Martin; Haag, Martin; Hoffmann, Georg F.; Tönshoff, Burkhard; Dolmans, Diana

doi:10.1080/0142159x.2017.1297525

Cited by 19 publications

(15 citation statements)

References 34 publications

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“…After students (n=377) underwent clinical clerkships and corresponding exams (n=11), they discussed in focus groups (n=8) the perception and impact of Key-Feature Problems with Long Menu (KFP) and context-rich Single Best Answer questions (crSBA). The study additionally compares the psychometric characteristics of the two formats [12]. …”

Section: Methodsmentioning

confidence: 99%

Design and implementation of virtual patients for learning of clinical reasoning

Huwendiek

2019

GMS Journal for Medical Education; 36(4):Doc33

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Section: Methodsmentioning

confidence: 99%

Design and implementation of virtual patients for learning of clinical reasoning

Huwendiek

2019

GMS Journal for Medical Education; 36(4):Doc33

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“…The moderator encouraged all of the participants to contribute, highlighted the value of differing opinions, and asked the participants to note down their thoughts on a given topic prior to the group discussion, in order to counteract the potential drawback of social pressure from peers or moderators inhibiting the open expression of opinions. Four two-hour focus group sessions were held on different days, moderated by one of the authors (SH), who is an experienced moderator of small groups, including focus groups (Huwendiek et al 2009(Huwendiek et al , 2017Huwendiek, Dunker, et al 2013). Consistency across group interviews was promoted by a questioning route (Krueger and Casey 2000) (Supplemental Appendix 1).…”

Section: Data Collectionmentioning

confidence: 99%

The introduction of a standardised national licensing exam as a driver of change in medical education: A qualitative study from Switzerland

Huwendiek

Jung²,

Schirlo

et al. 2020

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Introduction: Only a few studies have described the impacts, strengths and needs for further development of national licensing exams (NLE). To gain such insights regarding the Swiss NLE, which includes a multiple-choice and a standardised clinical skills exam, we explored the perceptions of involved experts and stakeholders. Methods: We explored participants' perceptions in four focus group discussions. The interviews were recorded, transcribed verbatim and qualitatively analysed using a thematic analysis approach. Results: The analysis resulted in five perceived impacts, two strengths and two needs for further developments of the NLE. Perceived impacts were (1) steering students' learning behaviour, (2) supporting teachers and assessors to align teaching to competencies, (3) elevating the importance of the Swiss Catalogue of Learning Objectives, (4) setting incentives for the further development of curricula, and (5) fostering the collaboration between the faculties of medicine. Perceived strengths were the blend of assessment formats, including their competency-based orientation, and the collaborative development approach. Perceived needs lay in the NLE's further development to sustain its fit for purpose and in incentives for people involved. Conclusion: According to our study, this NLE had, and has, notable impacts on medical education in Switzerland. Our insights can be useful for others planning a similar undertaking.

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“…These series of questions can be viewed as simulations [8] falling somewhere between multiple choice questions, which provide an assessment of the proficiency in applying knowledge to descriptions of clinical situations, and examinations with standardised patients, which provide a realistic context for assessing the skills involved in history-taking and performing physical examinations. Combining key-feature problems with long-menu formats seems to be very promising in terms of educational effect, perceived realism and acceptance by the students [9].…”

Section: Introductionmentioning

confidence: 99%

Comparison of long-menu and single-best-answer multiple choice questions in computer-based summative assessments: a randomised controlled trial

et al. 2019

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Background Little is known regarding the psychometric properties of computerized long-menu formats in comparison to classic formats. We compared single-best-answer (Type A) and long-menu formats using identical question stems during the computer-based, summative, intermediate clinical-clerkship exams for nine disciplines. Methods In this randomised sequential trial, we assigned the examinees for every summative exam to either the Type A or long-menu format (four different experimental questions, otherwise identical). The primary outcome was the power of discrimination. The study was carried out at the Faculty of Medicine, University of Geneva, Switzerland, and included all the students enrolled for the exams that were part of the study. Examinees were surveyed about the long-menu format at the end of the trial. Results The trial was stopped for futility ( p = 0.7948) after 22 exams including 88 experimental items. The long-menu format had a similar discriminatory power but was more difficult than the Type A format (71.45% vs 77.80%; p = 0.0001). Over half of the options (54.4%) chosen by the examinees in long-menu formats were not proposed as distractors in the Type A formats. Most examinees agreed that their reasoning strategy was different. Conclusions In a non-selected population of examinees taking summative exams, long-menu questions have the same discriminatory power as classic Type A questions, but they are slightly more difficult. They are perceived to be closer to real practice, which could have a positive educational impact. We would recommend their use in the final years of the curriculum, within realistic key-feature problems, to assess clinical reasoning and patient management skills.

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Electronic assessment of clinical reasoning in clerkships: A mixed-methods comparison of long-menu key-feature problems with context-rich single best answer questions

Abstract: KFPs with long-menu exams seem to bring about a positive educational effect without psychometric drawbacks.

Cited by 19 publications

References 34 publications

Design and implementation of virtual patients for learning of clinical reasoning

Design and implementation of virtual patients for learning of clinical reasoning

The introduction of a standardised national licensing exam as a driver of change in medical education: A qualitative study from Switzerland

Comparison of long-menu and single-best-answer multiple choice questions in computer-based summative assessments: a randomised controlled trial

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