The assessment of cognitive abilities in clinical medicine.

A study to test the hypotheses that discrete cognitive abilities necessary to clinical practice can be identified and their achievement reliably assessed by methods applicable to a large number of students is described. Eight supposedly discrete cognitive abilities related to clinical consultation were defined and the performance of medical students in them tested by short-answer question papers. In addition, knowledge of specific definitions and of therapeutics was examined. The study, conducted over one academic year, involved 222 medical students--102 in the penultimate, and 120 in the final year of their undergraduate course. Marking strictly to a previously agreed schedule was undertaken independently by three examiners; and students' performance in relation to each ability (and area of knowledge) determined. The findings showed intra- and inter-marker reliability to be highly satisfactory; and student performance in any one ability to be independent of that in any other. This suggests that the cognitive abilities chosen are indeed discrete. The importance of cognitive abilities is discussed in relation to education and training in clinical medicine.