Teaching and learning in medicine
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Construct: The definition of clinical reasoning may vary among health profession educators. However, for the purpose of this paper, clinical reasoning is defined as the cognitive processes that are involved in the steps of information gathering, problem representation, generating a differential diagnosis, providing a diagnostic justification to arrive at a leading diagnosis, and formulating diagnostic and management plans. Background: Expert performance in clinical reasoning is essential for success as a physician, and has been difficult for clerkship directors to observe and quantify in a way that fosters the instruction and assessment of clinical reasoning. ⋯ The overall MSX score was a significant predictor of Step 2 CS ICE score (ß = .19, P < .001), explaining an additional 4% of the variance of ICE beyond the NBME Medicine subject score and the Medicine OSCE score (Adjusted R2 = 13%). Conclusion: The stepwise format of the MSX provides a tool to observe clinical reasoning performance, which can be used in an assessment system to provide feedback to students on their analytical clinical reasoning. Future studies should focus on gaining additional validity evidence across different learners and multiple medical schools.
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Impostor phenomenon (IP) is a widely recognized experience in which highly performing individuals do not internalize success. Self-doubt toward one's ability or intelligence is unexpectedly common. Prior research has associated IP with medical student perceptions, burnout, and demographic characteristics. ⋯ This, along with the broad dispersion of scores within each of the four IP levels, suggests that students' internalization of achievement and feelings of IP are not consistently aligned with their actual performance on this assessment. Response variation on individual CIPS items suggest that underlying factors may drive variation in IP and performance. These results highlight the need for additional work to identify the constructs of IP that influence medical students specifically so that medical education stakeholders may better understand IP's impact on other facets of medical school and implement the resources necessary to support individuals who experience IP.