The influence of a digital clinical reasoning test on medical student learning behavior during clinical clerkships

Abstract

Abstract PURPOSE Recently, we developed a new digital clinical reasoning test (DCRT) to evaluate students’ clinical-reasoning skills. Although an assessment tool may be soundly constructed, it may still prove inadequate in practice by failing to function as intended. Therefore, more insight is needed into the effects of the DCRT in practice.MATERIALS & METHODS Individual semi-structured interviews and template analysis were used to collect and process qualitative data. The template, based on the interview guide, contained six themes: (1) DCRT itself, (2) test debriefing, (3) reflection, (4) practice/workplace, (5) DCRT versus practice and (6) ‘other’.RESULTS Thirteen students were interviewed. The DCRT evaluates the students’ clinical-reasoning skills adequately using six different question types. Students use the implicit and explicit feedback the DCRT provides for the improvement of their clinical-reasoning learning practice. By doing so, they show behavior consistent with self-directed learning and lifelong learning. Among other things, the DCRT encourages them to engage more in formal education and workplace-learning during their clerkships. Although the faculty emphasizes the different purposes of the DCRT (assessment of/for/as learning), students predominantly perceive the DCRT as an assessment solely of learning.CONCLUSION The implementation of a DCRT leads to successful stimulation of learning and practicing clinical-reasoning skills in the workplace.