Validation of a new measure of clinical problem‐solving

Summary. A review of the literature on the assessment of medical problem‐solving by means of written tests reveals serious shortcomings. Most important is the low correlation repeatedly found among cases, which suggests the inability of the measures to assess a general problem‐solving ability. The literature further suggests that instruments should focus on the brief period of time after the first encounter of a clinical problem and warns against the effects of cueing. Based on these considerations a new measure for the assessment of medical problem‐solving was developed. This test, called Simulation of Initial Medical Problem‐Solving (SIMP), consists of a number of short case histories, followed by an open‐ended question. Reliability analysed by means of generalizability theory proved satisfactory and concurrent validity was established by a significant correlation with a global judgement of performance in a simulated patient encounter.

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