Clinical Reasoning Assessment Methods: A Scoping Review and Practical Guidance

Abstract

Note: The term "resident" in this document refers to both specialty residents and subspecialty fellows. Once the Common Program Requirements are inserted into each set of specialty and subspecialty requirements, the terms "resident" and "fellow" will be used respectively. Where applicable, text in italics describes the underlying philosophy of the requirements in that section. These philosophic statements are not program requirements and are therefore not citable.

Heart Rate and Heart Rate Variability Correlate with Clinical Reasoning Performance and Self-Reported Measures of Cognitive Load

“…Clinical reasoning can be defined as the cognitive steps (e.g. information gathering, problem representation, generating and refining diagnostic hypotheses) leading up to and arriving at a diagnosis and a management plan 4–6 . Assessing the clinical reasoning performance, however, is challenging due to the limitations of the assessment methods, many of which do not incorporate the complexity and contextual nature of clinical reasoning as a construct 7 .…”

Teamwork in clinical reasoning – cooperative or parallel play?

“…Since the idea of a diagnostic team is relatively new, [29] there is are substantial knowledge gapsand research opportunitieswith respect to how best define and design these teams to optimize the diagnostic process and clinical reasoning outcomes. While there is much known about the assessment of individuals [30] and teams [31], we must develop and gather validity evidence for better tools that allow more meaningful measurement of diagnostic performance. With respect to team assessment, teamwork alone should not be the dependent variable of these assessmentsinstead, teamwork should be treated as an independent variable that leads to a clinically important outcome.…”

Aportes de la simulación al desarrollo del razonamiento clínico en estudiantes de pregrado de medicina

“…9 Existen diversos instrumentos descritos para evaluar el razonamiento clínico, los cuales se aplican fuera del contexto clínico (pruebas teóricas orales o escritas) en contextos simulados (OSCE o simulaciones) y en el campo clínico (observaciones de desempeño real, miniCEX o test de concordancia SCRIPT). 42 En una revisión sistemática sobre la conciencia de situación medida en exámenes OSCE y aplicada a estudiantes de medicina, 43 se sugiere que el desempeño en la tarea completa en un OSCE permite la evaluación de la conciencia de una situación asociada con el razonamiento clínico, y que el entregar un feedback sobre los desempeños observados promueve el desarrollo de esta competencia.…”