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Preferred question types for computer-based assessment of clinical reasoning: a literature study

机译：基于计算机的临床推理评估的首选问题类型：文献研究

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摘要

Clinical reasoning is a core competence of doctors. Therefore, the assessment of clinical reasoning of undergraduate students is an important part of medical education. Three medical universities in the Netherlands wish to develop a shared question database in order to assess clinical reasoning of undergraduate students in Computer-Based Assessments (CBA). To determine suitable question types for this purpose a literature study was carried out. Search of ERIC and PubMed and subsequent cross referencing yielded 30 articles which met the inclusion criteria of a focus on question types suitable to assess clinical reasoning of medical students and providing recommendations for their use. Script Concordance Tests, Extended Matching Questions, Comprehensive Integrative Puzzles, Modified Essay Questions/Short Answer Questions, Long Menu Questions, Multiple Choice Questions, Multiple True/False Questions and Virtual Patients meet the above-mentioned criteria, but for different reasons not all types can be used easily in CBA. A combination of Comprehensive Integrative Puzzles and Extended Matching Questions seems to assess most aspects of clinical reasoning and these question types can be adapted for use in CBA. Regardless of the question type chosen, patient vignettes should be used as a standard stimulus format to assess clinical reasoning. Further research is necessary to ensure that the combination of these question types produces valid assessments and reliable test results.
机译：临床推理是医生的核心能力。因此，对大学生临床推理的评估是医学教育的重要组成部分。荷兰的三所医科大学希望开发一个共享的问题数据库，以评估基于计算机的评估（CBA）中的大学生的临床推理。为了确定合适的问题类型，进行了文献研究。对ERIC和PubMed的检索以及随后的交叉引用产生了30篇文章，这些文章符合纳入标准的重点，这些问题集中在适合评估医学生临床推理并提供使用建议的问题类型上。脚本一致性测试，扩展匹配问题，综合性综合解题，修饰的作文问题/简短回答问题，长菜单问题，多项选择问题，多个对/错问题和虚拟患者均符合上述标准，但由于不同的原因，并非所有类型可以在CBA中轻松使用。综合综合谜题和扩展匹配问题的结合似乎可以评估临床推理的大多数方面，并且这些问题类型都可以用于CBA。无论选择哪种问题类型，都应将患者短片用作评估临床推理的标准刺激形式。必须进行进一步的研究以确保这些问题类型的组合产生有效的评估结果和可靠的测试结果。

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