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Combination of Different Clinical Reasoning Tests in a National Exam Publisher



Sadeghi A1 ; Asgari AA1 ; Moulaei N2 ; Mohammadkarimi V3 ; Delavari S4 ; Amini M5 ; Ri SN6 ; Akbari R7 ; Sanjari M8 ; Sedighi I9 ; Khoshnevisasl P10 ; Khoshbaten M11 ; Safari S12 ; Mohajerzadeh LL13 Show All Authors
Authors
  1. Sadeghi A1
  2. Asgari AA1
  3. Moulaei N2
  4. Mohammadkarimi V3
  5. Delavari S4
  6. Amini M5
  7. Ri SN6
  8. Akbari R7
  9. Sanjari M8
  10. Sedighi I9
  11. Khoshnevisasl P10
  12. Khoshbaten M11
  13. Safari S12
  14. Mohajerzadeh LL13
  15. Nabeiei P5
  16. Charlin B14
Show Affiliations
Authors Affiliations
  1. 1. Digestive Disease Research Institute, Tehran University of medical Sciences, Tehran, Iran
  2. 2. Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis, Institute, Zahedan University of Medical Sciences, Zahedan, Iran
  3. 3. Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  4. 4. Center for Educational Research in Medical Sciences (CERMS), Department of Medical Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  5. 5. Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  6. 6. Department of Gynecology Oncology, Iran University of Medical Sciences, Tehran, Iran
  7. 7. Department of Internal Medicine, Babol University of Medical Sciences, Babol, Iran
  8. 8. Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
  9. 9. Department of Pediatric, School of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran
  10. 10. Zanjan Social determinants of health research center, Zanjan University of Medical Sciences, Zanjan, Iran
  11. 11. Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of M/edical Sciences, Tabriz, Iran
  12. 12. Department of Surgery, Firoozgar general hospital, Iran University of Medical Sciences, Tehran, Iran
  13. 13. Pediatric Surgery Research Center (PSRC), Research Institute for Children Health (RICH), Mofid Children’s Hospital (MCH), Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
  14. 14. Medical School, University of Montreal, Montreal, Canada

Source: Journal of Advances in Medical Education and Professionalism Published:2019


Abstract

Introduction: Clinical reasoning as a critical and high level of clinical competency should be acquired during medical education, and medical educators should attempt to assess this ability in medical students. Nowadays, there are several ways to evaluate medical students’ clinical reasoning ability in different countries worldwide. There are some well-known clinical reasoning tests such as Key Feature (KF), Clinical Reasoning Problem (CRP), Script Concordance Test (SCT), and Comprehensive Integrative Puzzle (CIP). Each of these tests has its advantages and disadvantages. In this study, we evaluated the reliability of combination of clinical reasoning tests SCT, KF, CIP, and CRP in one national exam and the correlation between the subtest scores of these tests together with the total score of the exam. Methods: A total of 339 high ranked medical students from 60 medical schools in Iran participated in a national exam named “Medical Olympiad”. The ninth Medical Olympiad was held in Shahid Beheshti University of Medical Sciences, Tehran, Iran, under the direct supervision of the Ministry of Health and Medical Education in summer 2017. The expert group designed a combination of four types of clinical reasoning tests to assess both analytical and non-analytical clinical reasoning. Mean scores of SCT, CRP, KF, and CIP were measured using descriptive statistics. Reliability was calculated for each test and the combination of tests using Cronbach’s alpha. Spearman’s correlation coefficient was used to evaluate the correlation between the score of each subtest and the total score. SPSS version 21 was used for data analysis and the level of significance was considered <0.05. Results: The reliability of the combination of tests was 0.815. The reliability of KF was 0.81 and 0.76, 0.80, and 0.92 for SCT, CRP, and CIP, respectively. The mean total score was 169.921±41.54 from 240. All correlations between each clinical reasoning test and total score were significant (P<0.001). The highest correlation (0.887) was seen between CIP score and total score. Conclusion: The study showed that combining different clinical reasoning tests can be a reliable way of measuring this ability. © 2019, Shiraz University of Medical Sciences. All rights reserved.
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