Table.

Methods of assessing clinical reasoning.

Assessment method	Description
Chart stimulated recall	Using the patient chart generated by the clinician, probe for recall of the reasoning process in connection with key elements of the chart.
Concept map	Graphic representation of knowledge constructs and relationships among them (organization). Used for both teaching and assessment.
Direct observation	Observation in a clinical reasoning task and judgment of performance against specified criteria.
Extended matching, multiple choice questions	Select best response from a restricted number of alternative answers. Most commonly used to asses knowledge, but amenable to more sophisticated tasks.
Patient management problems	A structured patient case that allows flexible selection of clinical information and the development of a dynamic diagnostic or management decision.
Post-encounter note	Written summary of patient case, relevant information, diagnosis, and treatment plan.
Script concordance tests	Assesses the impact of new information on a diagnostic hypothesis or the probability pursuing a specified action.
Simulation, standardized patients	Structured patient case with a trained actor that requires the learner to do a history and physical examination and generate a diagnostic solution.
Think aloud, oral exam	Verbalize one’s reasoning process as one works through a clinical case or specified problem – with or without prompts and probes from an examiner.