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Clinical prioritisation questions: A novel assessment tool to encourage tolerance of uncertainty?

机译：临床优先级分辨率问题：一种新的评估工具，鼓励耐受不确定性的宽容？

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摘要

Uncertainty is a common and increasingly acknowledged problem in clinical practice. Current single best answer (SBA) style assessments test areas where there is one correct answer, and as the approach to assessment impacts on the approach to learning, these exams may poorly prepare our future doctors to handle uncertainty. We therefore, need to modify our approach to assessment to emphasize reasoning and introduce the possibility of more than one 'correct' answer. We have developed clinical prioritization questions (CPQs), a novel formative assessment tool in which students prioritize possible responses in order of likelihood. This assessment format was piloted with a group of medical students and evaluated in comparison with the more traditional SBA question format in a team-based learning setting. Students reported that they felt ongoing use would help improve their tolerance of uncertainty (p < 0.01). Furthermore, over 80% of students felt that CPQs were more reflective of real-life clinical practice. Group based discussions were significantly longer when answering CPQs (p < 0.01), suggesting they may promote richer discourse. CPQs may have a role in formative assessment to help equip students with the skills to cope with ambiguity and strengthen clinical reasoning and decision-making. Institutions may find them more practical to implement compared with other clinical reasoning assessment tools.
机译：不确定性是临床实践中共同且越来越承认的问题。目前的单一最佳答案（SBA）风格评估测试领域有一个正确答案的测试领域，并且作为评估对学习方法的影响的方法，这些考试可能会使我们未来的医生造成不确定性的不确定。因此，我们需要修改我们的方法来评估，以强调推理并介绍多个“正确”答案的可能性。我们开发了临床优先级次序问题（CPQ），这是一种新型的形成性评估工具，其中学生以可能性的秩序优先考虑可能的反应。此评估格式被一群医学生试点，并与基于团队的学习环境中的传统SBA问题格式相比，评估。学生报告说，他们感到持续使用会有助于提高他们对不确定性的耐受性（P <0.01）。此外，超过80％的学生认为CPQs更加反映现实生活临床实践。在回答CPQS时，基于群体的讨论明显更长（P <0.01），表明他们可能会促进更丰富的话语。 CPQs可能在形成性评估中具有作用，以帮助为学生提供应对歧义和加强临床推理和决策的技能。与其他临床推理评估工具相比，机构可能会发现它们更加实用。

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