ContExtended Questions (CEQ) to Teach and Assess Clinical Reasoning: A New Variant of F-Type Testlets

Abstract

This study introduces ContExtended Questions (CEQ), which is a toolboth to teach and assess clinical reasoning particularly in the preclinical years,and the web-based program to implement. CEQ consists of text-based case-basedmultiple-choice questions that provide patient data in a fixed and predeterminedsequence. It enables the examinees to develop and reshape their illness scripts byusing feedback after every question. Feedback operates to transform theexaminee’s failure into a “productive failure”. The preliminary results of therandomized controlled experiment of teaching clinical reasoning to preclinicalstudents through CEQ is quite satisfactory. In the medical education literature,this would be the first time that students, who have no or very limited clinicalexperience, developed their illness scripts just by taking formative multiple-choicetests. The approach would be named “test-only learning”. The complete results ofthe experiment and then more experiments in other contexts and domains arenecessary to establish a more powerful assessment tool and software.Furthermore, by changing the content of the questions, it is possible to use CEQ inevery period of medical education and health professions education.