Division of Emergency Medicine, Duke University, Durham, NC, USA.
Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
Perspect Med Educ. 2022 Mar;11(2):108-114. doi: 10.1007/s40037-022-00701-3. Epub 2022 Mar 7.
The importance of clinical reasoning in patient care is well-recognized across all health professions. Validity evidence supporting high quality clinical reasoning assessment is essential to ensure health professional schools are graduating learners competent in this domain. However, through the course of a large scoping review, we encountered inconsistent terminology for clinical reasoning and inconsistent reporting of methodology, reflecting a somewhat fractured body of literature on clinical reasoning assessment. These inconsistencies impeded our ability to synthesize across studies and appropriately compare assessment tools. More specifically, we encountered: 1) a wide array of clinical reasoning-like terms that were rarely defined or informed by a conceptual framework, 2) limited details of assessment methodology, and 3) inconsistent reporting of the steps taken to establish validity evidence for clinical reasoning assessments. Consolidating our experience in conducting this review, we provide recommendations on key definitional and methodologic elements to better support the development, description, study, and reporting of clinical reasoning assessments.
临床推理在患者护理中的重要性在所有医疗保健专业中都得到了广泛认可。支持高质量临床推理评估的有效性证据对于确保医疗保健专业学校培养出在该领域有能力的学习者至关重要。然而，在进行大规模的范围综述过程中，我们遇到了临床推理术语不一致和方法报告不一致的情况，这反映了临床推理评估文献存在一定的分散。这些不一致性阻碍了我们在研究之间进行综合以及适当比较评估工具的能力。更具体地说，我们遇到了以下问题：1）广泛的临床推理类似术语，这些术语很少被定义或由概念框架提供信息；2）评估方法的细节有限；3）临床推理评估的有效性证据建立步骤的报告不一致。综合我们在进行这项综述方面的经验，我们提供了关于关键定义和方法要素的建议，以更好地支持临床推理评估的开发、描述、研究和报告。
