Clinical reasoning exercises
المؤلف:
Larry W. Belbeck & Shucui Jiang & Nicoleta Nutiu
المصدر:
Enhancing Teaching and Learning through Assessment
الجزء والصفحة:
P231-C20
2025-07-10
470
Clinical reasoning exercises
The students would be presented with a one or two sentence scenario and expected to produce a list of possible reasons for the condition. These could also be in the form of possible answers to a question or the name of a disease likely to produce the physiological or pathological change.
The scoring was based on one mark for a relevant answer, no mark for a neutral answer and a deduction of one mark for an irrelevant or dangerous answer.
An example might be appropriate.
"A healthy sixty-six-year-old gentleman collapses with retrosternal chest pain radiating to the left arm."
Relevant answers would include myocardial infarction, aortic aneurysm and pulmonary embolism, all of which are sudden and catastrophic in onset. Neutral answers might be lung neoplasia which may remain silent for a long period of time and rapidly exacerbate. Answers such as chronic obstructive lung disease, most infectious diseases and congenital disease would result in the loss of a mark.
The test was carried out in an examination setting, where students received the problems and were required to write answers in a defined period of time without collaboration or additional resources. Thus part of their score was based on the information that they knew.
During the next twenty-four hours, students could submit electronically refined answers or additional reasons and receive sixty percent of the mark they would have received and presented the material during the first part of the examination.
Neutral and deductions for inappropriate answers were on the same basis as the first part of the exercise. The purpose of this was to encourage further refinement of the best possible answers. Since there were no restrictions on resources, inappropriate answers were penalized at the initial higher one mark rate.
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