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Do extended matching multiple-choice questions measure clinical reasoning?
Med Educ. 2005 Apr; 39(4):410-7.ME

Abstract

PURPOSE

At the Faculty of Medicine at the Katholieke Universiteit Leuven, Belgium, we have developed a final examination that consists of extended matching multiple-choice questions. Extended matching questions (EMQs) originate from a case and have 1 correct answer within a list of at least 7 alternatives. If EMQs assess clinical reasoning, we can assume there will be a difference between the ways students and experienced doctors solve the problems within the questions. This study compared students' and residents' processes of solving EMQs.

METHODS

Twenty final year students and 20 fourth or fifth year residents specialising in internal medicine solved 20 EMQs aloud. All questions concerned diagnosis or pathogenesis. Ten EMQs related to internal medicine and 10 questions to other medical disciplines. The session was audio-taped and transcribed.

RESULTS

The residents correctly answered significantly more questions concerning internal medicine than did the students. Their reasoning was more "forward" and less "backward". No difference between residents and students was found for the other questions. The residents scored better on internal medicine than on the other questions. They used more backward and less forward reasoning when solving the other questions than they did with the internal medicine questions. The better half of the respondents used significantly more forward and less backward reasoning than did the poorer half.

CONCLUSION

In accordance with the literature, medical expertise was characterised by forward reasoning, whereas outside their area of expertise, the subjects switched over to backward reasoning. It is possible to assess processes of clinical reasoning using EMQs.

Authors+Show Affiliations

Centre for Medical Education, Faculty of Medicine, Katholieke Universiteit Leuven, Minderbroederstraat 17, B-3000 Leuven, Belgium. Johan.Beullens@med.kuleuven.ac.beNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15813764

Citation

Beullens, Johan, et al. "Do Extended Matching Multiple-choice Questions Measure Clinical Reasoning?" Medical Education, vol. 39, no. 4, 2005, pp. 410-7.
Beullens J, Struyf E, Van Damme B. Do extended matching multiple-choice questions measure clinical reasoning? Med Educ. 2005;39(4):410-7.
Beullens, J., Struyf, E., & Van Damme, B. (2005). Do extended matching multiple-choice questions measure clinical reasoning? Medical Education, 39(4), 410-7.
Beullens J, Struyf E, Van Damme B. Do Extended Matching Multiple-choice Questions Measure Clinical Reasoning. Med Educ. 2005;39(4):410-7. PubMed PMID: 15813764.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Do extended matching multiple-choice questions measure clinical reasoning? AU - Beullens,Johan, AU - Struyf,Elke, AU - Van Damme,Bo, PY - 2005/4/9/pubmed PY - 2005/6/7/medline PY - 2005/4/9/entrez SP - 410 EP - 7 JF - Medical education JO - Med Educ VL - 39 IS - 4 N2 - PURPOSE: At the Faculty of Medicine at the Katholieke Universiteit Leuven, Belgium, we have developed a final examination that consists of extended matching multiple-choice questions. Extended matching questions (EMQs) originate from a case and have 1 correct answer within a list of at least 7 alternatives. If EMQs assess clinical reasoning, we can assume there will be a difference between the ways students and experienced doctors solve the problems within the questions. This study compared students' and residents' processes of solving EMQs. METHODS: Twenty final year students and 20 fourth or fifth year residents specialising in internal medicine solved 20 EMQs aloud. All questions concerned diagnosis or pathogenesis. Ten EMQs related to internal medicine and 10 questions to other medical disciplines. The session was audio-taped and transcribed. RESULTS: The residents correctly answered significantly more questions concerning internal medicine than did the students. Their reasoning was more "forward" and less "backward". No difference between residents and students was found for the other questions. The residents scored better on internal medicine than on the other questions. They used more backward and less forward reasoning when solving the other questions than they did with the internal medicine questions. The better half of the respondents used significantly more forward and less backward reasoning than did the poorer half. CONCLUSION: In accordance with the literature, medical expertise was characterised by forward reasoning, whereas outside their area of expertise, the subjects switched over to backward reasoning. It is possible to assess processes of clinical reasoning using EMQs. SN - 0308-0110 UR - https://www.unboundmedicine.com/medline/citation/15813764/Do_extended_matching_multiple_choice_questions_measure_clinical_reasoning DB - PRIME DP - Unbound Medicine ER -