Convergent Validity of a Novel Clinical Reasoning Tool in Clerkship Medical Students: Pilot Study
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SHORT COMMUNICATION
Convergent Validity of a Novel Clinical Reasoning Tool in Clerkship Medical Students: Pilot Study Yvonne N. Covin 1
&
Neda Wick 2 & Palma J. Longo 3
# International Association of Medical Science Educators 2019
Abstract Medical student educators have limited tools for standardized clinical reasoning assessment. The clinical reasoning task (CRT) checklist has been shown to identify specific tasks in the diagnostic process among residents and faculty. Authors assessed a novel student think aloud protocol strategy, the CRT, compared with the validated clinical data interpretation (CDI) test in six third-year medical students. The CRT was scored by two independent reviewers (kappa = 0.88). CRT and CDI scores were strongly positively correlated (r = 0.768, p = 0.074, df = 4). CRT provides both a global assessment of clinical reasoning and specific clinical reasoning deficits. Keywords Clinical reasoning . Feedback . Medical students . Undergraduate medical education research
Background At the time of graduation, medical students must demonstrate appropriate clinical reasoning capability to safely transition to residency. Current instruments for clinical reasoning assessment vary in feedback provided to students for personal growth [1, 2]. Although clinical reasoning is a dominant remediation area, representing 40% of deficits, there are limited validated instruments to assess specific deficits for feedback [1, 3]. The clinical reasoning task (CRT) checklist has been shown to identify specific tasks in the diagnostic process among residents, faculty, and students [4–6]. Publications of its use describe validity arguments of content (“topic of interest”), response process (“rater and examinee actions alignment with construct”), internal structure (“reliability, item analysis, and factor analysis”), according to Messick’s criteria [7]. However,
* Yvonne N. Covin [email protected] 1
Department of Internal Medicine, UT Health San Antonio, San Antonio, TX, USA
2
Department of Pathology, UT Southwestern Medical Center, Dallas, TX, USA
3
Department of Healthcare Sciences, UT Southwestern Medical Center, Dallas, TX, USA
no evidence of CRT’s convergent validity exists. Convergent validity is the argument which an evaluation strategy is shown to correlate (or not) with other instruments designed to measure theoretically comparable constructs [7]. The purpose of this study was to describe the convergent validity of a novel assessment method: the think aloud protocol strategy scored with the CRT [6]. The study was accomplished by (a) describing frequency of CRT checklist item use among clerkship medical students (year three), and (b) comparing CRT checklist scores to a validated instrument, the clinical data interpretation (CDI) test, which provides a global assessment of clinical reasoning but does not assess proficiency in specific tasks.
Activity In June 2016, six third-year medical students were consented during their ambulatory internal medicine clerkship. No exclusion criteria applied. Studen
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