Evaluating the Clinical Reasoning of Student Health Professionals in Placement and Simulation Settings: A Systematic Review

(1) Background: Clinical reasoning is essential to the effective practice of autonomous health professionals and is, therefore, an essential capability to develop as students. This review aimed to systematically identify the tools available to health professional educators to evaluate students’ attainment of clinical reasoning capabilities in clinical placement and simulation settings. (2) Methods: A systemic review of seven databases was undertaken. Peer-reviewed, English-language publications reporting studies that developed or tested relevant tools were included. Searches included multiple terms related to clinical reasoning and health disciplines. Data regarding each tool’s conceptual basis and evaluated constructs were systematically extracted and analysed. (3) Results: Most of the 61 included papers evaluated students in medical and nursing disciplines, and over half reported on the Script Concordance Test or Lasater Clinical Judgement Rubric. A number of conceptual frameworks were referenced, though many papers did not reference any framework. (4) Conclusions: Overall, key outcomes highlighted an emphasis on diagnostic reasoning, as opposed to management reasoning. Tools were predominantly aligned with individual health disciplines and with limited cross-referencing within the field. Future research into clinical reasoning evaluation tools should build on and refer to existing approaches and consider contributions across professional disciplinary divides.

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Assessing Clinical Reasoning in Pediatric Emergency Medicine: Validity Evidence for a Script Concordance Test

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2008.07.024 ◽

2009 ◽

Vol 53 (5) ◽

pp. 647-652 ◽

Cited By ~ 44

Author(s):

Benoit Carrière ◽

Robert Gagnon ◽

Bernard Charlin ◽

Steven Downing ◽

Georges Bordage

Keyword(s):

Emergency Medicine ◽

Clinical Reasoning ◽

Pediatric Emergency ◽

Validity Evidence ◽

Pediatric Emergency Medicine ◽

Script Concordance Test ◽

Concordance Test ◽

Script Concordance

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The Use of a Modified Script Concordance Test in Clinical Rounds to Foster and Assess Clinical Reasoning Skills

Journal of Veterinary Medical Education ◽

10.3138/jvme-2021-0090 ◽

2021 ◽

Author(s):

Jordan D. Tayce ◽

Ashley B. Saunders

Keyword(s):

Clinical Reasoning ◽

Assessment For Learning ◽

Learning Activity ◽

Free Text ◽

Valuable Insight ◽

Script Concordance Test ◽

Concordance Test ◽

Script Concordance ◽

Reasoning Skills ◽

Clinical Reasoning Skills

The development of clinical reasoning skills is a high priority during clinical service, but an unpredictable case load and limited time for formal instruction makes it challenging for faculty to foster and assess students’ individual clinical reasoning skills. We developed an assessment for learning activity that helps students build their clinical reasoning skills based on a modified version of the script concordance test (SCT). To modify the standard SCT, we simplified it by limiting students to a 3-point Likert scale instead of a 5-point scale and added a free-text box for students to provide justification for their answer. Students completed the modified SCT during clinical rounds to prompt a group discussion with the instructor. Student feedback was positive, and the instructor gained valuable insight into the students’ thought process. A modified SCT can be adopted as part of a multimodal approach to teaching on the clinic floor. The purpose of this article is to describe our modifications to the standard SCT and findings from implementation in a clinical rounds setting as a method of formative assessment for learning and developing clinical reasoning skills.

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