A test of medical problem‐solving scored by nurses and doctors: the handicap of expertise

Summary. There is evidence that nurses fulfil the requirements of objective judgement better than doctors. Simulation of Initial Medical Problem‐Solving (SIMP), a paper‐and‐pencil test for the assessment of medical problem‐solving, consists of case histories, followed by an open‐ended question. The scoring of open‐ended questions is time‐consuming and adds subjective bias to measurement error. In order to reduce scoring error, answers on SIMP are scored by means of scoring models in the form of check‐lists with descriptions of elements of a correct answer. The reliability of the scoring was analysed in a study, with six nurses rating 500 answers.