Formative Assessment of Diagnostic Testing in Family Medicine with Comprehensive MCQ Followed by Certainty-Based Mark

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Abstract

Introduction: The choice of diagnostic tests in front of a given clinical case is a major part of medical reasoning. Failure to prescribe the right test can lead to serious diagnostic errors. Furthermore, unnecessary medical tests are a waste of money and could possibly generate injuries to patients, especially in family medicine. Methods: In an effort to improve the training of our students to the choice of laboratory and imaging studies, we implemented a specific multiple-choice questions (MCQ), called comprehensive MCQ (cMCQ), with a fixed and high number of options matching various basic medical tests, followed by a certainty-based mark (CBM). This tool was used in the assessment of diagnostic test choice in various clinical cases of general practice in 456 sixth-year medical students. Results: The scores were significantly correlated with the traditional exams (standard MCQ), with matched themes. The proportion of “cMCQ/CBM score” variance explained by “standard MCQ score” was 21.3%. The cMCQ placed students in a situation closer to practice reality than standard MCQ. In addition to its usefulness as an assessment tool, those tests had a formative value and allowed students to work on their ability to measure their doubt/certainty in order to develop a reflexive approach, required for their future professional practice. Conclusion: cMCQ followed by CBM is a feasible and reliable evaluation method for the assessment of diagnostic testing.

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Herbaux, C., Dupré, A., Rénier, W., Gabellier, L., Chazard, E., Lambert, P., … Truffert, P. (2022). Formative Assessment of Diagnostic Testing in Family Medicine with Comprehensive MCQ Followed by Certainty-Based Mark. Healthcare (Switzerland), 10(8). https://doi.org/10.3390/healthcare10081558

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