Assessing Clinical Reasoning in the Workplace

Chapter 7 discussed cognitive assessment in more standardized and controlled situations, highlighting the different methods and techniques—including multiple-choice, essay, concept mapping, script concordance testing, and key feature approaches—one can use to explore constructs such as clinical reasoning in written formats. Additional chapters in this book have addressed other standardized performance formats, such as objective structured clinical examinations (OSCEs), for assessing topics like clinical reasoning. In this chapter we discuss assessment of clinical reasoning (i.e., a construct of assessment) from an in vivo or workplace perspective and build upon discussions from prior chapters. While clinical reasoning will be used as the construct of focus for this chapter, aspects of this discussion may also apply to other important assessment constructs germane to the workplace the reader might have in mind, such as professionalism and teamwork. We will begin with a background, followed by a theoretical framework and then a description of selected emerging methods for workplace-based assessment (WBA) at both the individual learner and program levels that could be used in the local context. We will end with notable challenges and opportunities with these emerging methods..