10 Tools or Methods (with Examples) for Assessment of Clinical Reasoning

Medical Education Flamingo
3 min readDec 15, 2023


Are you curious about the tools or methods of assessing clinical reasoning and want to see some examples? This video is the most concise (3-mins) source for you.

Hi and hola para amigos.

Today, we’ll be exploring 10 assessment methods in medical education to assess clinical reasoning in classrooms. These are the tools that are classified as non-workplace-based assessment.

Our first method is Multiple Choice Questions or MCQs. These questions consist of a clinical vignette followed by up to five potential answers. They may be structured to require a single best answer, a combination of alternatives, true or false for each alternative, or matching.

Next, we have Extended Matching Questions or EMQs. These resemble MCQs but include longer lists of potential answers applied to multiple questions.

Moving on to Key Feature Examinations or Questions, this method contains clinical vignettes followed by questions focused on critical steps in clinical decision making, with case-specific key features.

Script Concordance Tests or SCTs involve short clinical scenarios representing uncertainty. Learners answer questions based on how new information is processed during clinical reasoning, and responses are compared with those of a reference panel of experts.

Short- or Long-Answer (Essay) Questions, this method involves a clinical vignette followed by one or more questions answered using constructed free-text responses.

Modified Essay Questions present serial information about a case chronologically. Learners must document decisions in a constructed free-text format before moving on to subsequent items.

Patient Management Problems consist of context-rich clinical scenarios where learners select among multiple alternatives for action, and the results of those actions are provided as they progress through the case.

Clinical or Comprehensive Integrative Puzzles take the form of a grid where findings are placed in columns (e.g., history, physical, ECG) and related diagnoses in rows. Learners compare and contrast items to build basic illness scripts.

Concept Maps are a schematic assessment method where learners represent their knowledge of a domain through graphical illustrations, outlining concepts and their relationships.

Lastly, we have Oral Examinations, verbal assessments conducted by faculty members to evaluate clinical reasoning, decision-making abilities, and professional values.

And there you have it — a brief overview of 10 assessment methods in medical education, each offering unique ways to evaluate learners in the classroom. Don’t forget that each has strengths and weaknesses, so use them by making informed decisions depending on your unique context.

Several non-workplace-based assessment methods are used for medium- to high-stakes examinations, such as multiple-choice questions and key-feature questions for summative assessments. Others like concept maps are more suitable for formative assessments or research.

If you want to learn more about these methods and how to use them, I left links to the publications for further reading at the description below. All are scientific sources to help you in an evidence-based way. Thank you for watching, and don’t forget to like and subscribe for more content like this. If you have any questions, feel free to leave them in the comments below the video: https://youtu.be/glBq3HQ-YFY?feature=shared

See you and adios para amigos.

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