How we measure problem-solving ability

Marshall, Jack

doi:10.1111/j.1365-2923.1983.tb00966.x

Medical Education

1983

DOI: 10.1111/j.1365-2923.1983.tb00966.x

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How we measure problem-solving ability

Jack Marshall

Abstract: A review of some of the more recent literature on problem solving is presented. An attempt is made to identify factors which may lead to discrediting the PMP (Patient Management Problem) as a measure of problem-solving ability. A definition of competence in problem solving is proposed and the question of scoring is discussed. A possible method for future research is suggested.

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1988

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“…The technique described, sometimes with minor changes, has been used or specifically mentioned by many researchers, including Helfer & Slater (1971), Grinker (1972), Bertin (1974), Distlehorst & Barrows (1982), Gale & Marsden (1982) and Marshall (1983), while others have misused it in various contexts by using leading questions, forced branchings, interruptions of the subjects' process, etc, as pointed out by Libonatti (1978). This makes it difficult if not impossible to learn what the subject really does.…”

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Diagnosing the diagnostic process

Rimoldi

1988

Medical Education

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Experimental results obtained by examining the diagnostic performance of students and doctors in different medical schools and different cultural environments are presented. The pertinent data were obtained using tests of diagnostic skills based on real cases. The technique requires asking questions (tactics) to obtain the information needed to reach a diagnosis so that the subject becomes an active searcher of information and the final answer is not the only element used to evaluate tactics. The results show significant differences in performance according to medical experience. Experts ask fewer questions than students or less-experienced doctors but maximize the information value by asking them at the proper time in the sequence. New evaluation procedures are described to characterize quantitatively each diagnostic tactic. Experimentally based theoretical considerations are made concerning the prediction and development of diagnostic talent, the structure of diagnostic processes and its training. New approaches to the problem are briefly sketched.

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Diagnosing the diagnostic process

Rimoldi

1988

Medical Education

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The Dimensionality of Measures Derived from a Nationally Standardized Written Clinical Simulation Examination

Cavanaugh

Loadman

1988

Eval Health Prof

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The literature reflects substantial controversy regarding the dimensionality of various scores derived from a variety of patient management problem tests. The purposes of this study were to determine (1) the dimensionality of 20 problem score measures derived from a nationally standardized written clinical simulation examination and (2) the stability and generalizability of the resulting factor structure across both examinee groups and test forms. Test score data from two independent national samples that completed the same test form were obtained (Ni = 2,812; N2 = 312); a third independent national sample completed a different test form (N3 = 2,546). Each of the three 20 x 20 intercorrelations was subjected to confirmatory factor analysis in an attempt to validate a two-dimensional solution, but such a solution could not be substantiated. Subsequent exploratory factor analyses yielded consistent one-factor solutions for each of the three data sets, demonstrating generalizability and stability of this one-factor structure across both different groups of examinees and different tests forms. This study clearly demonstrated that for the examination under study, there is only one underlying dimension rather than two as suggested in the literature and reflected in the existing test scoring practice.

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How we measure problem-solving ability

Cited by 2 publications

References 18 publications

Diagnosing the diagnostic process

Diagnosing the diagnostic process

The Dimensionality of Measures Derived from a Nationally Standardized Written Clinical Simulation Examination

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