Abstract
The last century saw dramatic changes in clinical practice and medical education and the concomitant rise in high-stakes, psychometrically-based examinations of medical knowledge. Higher scores on these high-stakes "in-vitro" examinations are modestly associated with better performance in clinical practice and provide a meaningful degree of assurance to the public about physicians' competency in medical knowledge. However, results on such examinations explain only a small fraction of the wide variation currently seen in clinical practice and diagnostic errors remain a serious and vexing problem for patients and the healthcare system despite decades of high-stakes examinations. In this commentary we explore some of the limitations of high-stakes examinations in assessing clinical reasoning and propose utilizing situated cognition theory to guide research and development of innovative modes of "in-vivo" assessments that can be used in longitudinally and continuously in clinical practice.
| Original language | English |
|---|---|
| Pages (from-to) | 111-117 |
| Number of pages | 7 |
| Journal | Diagnosis |
| Volume | 1 |
| Issue number | 1 |
| DOIs | |
| State | Published - 1 Jan 2014 |
| Externally published | Yes |
Keywords
- Clinical decision making
- Clinical reasoning
- Diagnostic error