ArticleJournal of graduate medical education2014
Exploring Clinical Reasoning Strategies and Test-Taking Behaviors During Clinical Vignette Style Multiple-Choice Examinations: A Mixed Methods Study.
Article in Journal of graduate medical education, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Less is more? A systematic review and network meta-analysis on MCQ option numbers.BMC medical education · 2025Pooled it
- Comparison of Online Peer-Assisted Learning and Faculty-Led Teaching for Short Answer Questions.The clinical teacher · 2025Trial
- Leveraging computerized adaptive testing for cost-effective evaluation of large language models in medical benchmarking.NPJ digital medicine · 2026Article
- Visualizing cognitive processes in medical education: Forward and backward reasoning in a digital family medicine assessment.GMS journal for medical education · 2026Article
- A Systematic Review and Meta-Analysis on the Impact of Peer-Made MCQ Question-Bank Usage on Summative Assessments in Medical Education.Journal of advances in medical education & professionalism · 2025Review
- A Qualitative Exploration of Student Cognition When Answering Text-Only or Image-Based Histology Multiple-Choice Questions.Medical science educator · 2024Article
- Using ChatGPT in Psychiatry to Design Script Concordance Tests in Undergraduate Medical Education: Mixed Methods Study.JMIR medical education · 2024Article
- Automated Item Generation: impact of item variants on performance and standard setting.BMC medical education · 2023Article
- Functional near-infrared spectroscopy of medical students answering various item types.Frontiers in psychology · 2023Article
- Associations between item characteristics and statistical performance for paediatric medical student multiple choice assessments.MedEdPublish (2016) · 2023Article
- Examining Bloom's Taxonomy in Multiple Choice Questions: Students' Approach to Questions.Medical science educator · 2021Article
- Article
- A mixed-methods exploration of cognitive dispositions to respond and clinical reasoning errors with multiple choice questions.BMC medical education · 2018Article
- Multifaceted remediation program: experience of a residency program to rescue residents who failed the American Board of Anesthesiology basic examination.Advances in medical education and practice · 2018Article
- Clinical Reasoning Terms Included in Clinical Problem Solving Exercises?Journal of graduate medical education · 2016Article
- Now You See It, Now You Don't: What Thinking Aloud Tells Us About Clinical Reasoning.Journal of graduate medical education · 2014Article
- Coproducing the Learning Environment: Lessons Learned from a Year of Near-Peer Teaching.Journal of medical education and curricular developmentArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinical vignette multiple-choice questions (MCQs) are widely used in medical education, but clinical reasoning (CR) strategies employed when approaching these questions have not been well described.
objectivesThe aims of the study were (1) to identify CR strategies and test-taking (TT) behaviors of physician trainees while solving clinical vignette MCQs; and (2) to examine the relationships between CR strategies and behaviors, and performance on a high-stakes clinical vignette MCQ examination.
methodsThirteen postgraduate year-1 level trainees completed 6 clinical vignette MCQs using a think-aloud protocol. Thematic analysis employing elements of grounded theory was performed on data transcriptions to identify CR strategies and TT behaviors. Participants' CR strategies and TT behaviors were then compared with their US Medical Licensing Examination Step 2 Clinical Knowledge scores.
resultsTwelve CR strategies and TT behaviors were identified. Individuals with low performance on Step 2 Clinical Knowledge demonstrated increased premature closure and increased faulty knowledge, and showed comparatively less ruling out of alternatives or admission of knowledge deficits. High performers on Step 2 Clinical Knowledge demonstrated increased ruling out of alternatives and admission of knowledge deficits, and less premature closure, faulty knowledge, or closure prior to reading the alternatives.
conclusionsDifferent patterns of CR strategies and TT behaviors may be used by high and low performers during high-stakes clinical vignette MCQ examinations.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.