Developing A new method and electronic system for assessment of clinical reasoning skills in medical education

Clinical reasoning is an important skill in medical education. The methods that are used for teaching clinical reasoning in the preclinical period have various limitations. In the meantime, "assessment for learning" is becoming more important than "assessment of learning". Thus, the aims of this thesis are to develop a new assessment tool for clinical reasoning, to develop an electronic system for implementation, to determine the effect of the tool on learning clinical reasoning skills in the preclinical medical students, and to collect validity evidence for the tool. The tool has been developed based on script theory and "productive failure" approach. The tool was named "ContExtended Questions" since it pays high attention to context, and it has similarities with the options of Extended Matching Questions type. The tool has two versions: with feedback and without feedback. The results of the randomized controlled study showed for the first time in medical education literature that the preclinical medical students can develop their clinical reasoning skills and illness scripts by answering multiple-choice testlets with feedback and without any additional teaching. The results of the "without feedback" implementation indicated that many aspects of the tool have similar levels to Key-Features Questions in terms of psychometric features. As a conclusion, ContExtended Questions is an assessment tool that comes to the fore with its "with feedback" version and is more suitable to be used for formative purposes. Especially if it would be used for formative assessment, it could deeply contribute to the vertical integration of curricula of the medical schools. As for the clinical period, it can be used for the purpose of "test-enhanced learning" as an addition to existing teaching activities. Apart from these, new studies conducted with other health professions students such as nursing, pharmacy, and dentistry could show that the tool can also be used in these areas.