Background &amp; Need for Innovation: Objective Structured Clinical Examinations (OSCEs) are commonly employed to assess clinical skills. While several existing tools address components of clinical reasoning, including the Assessment of Reasoning Tool, none are calibrated for competency-based assessment of medical students (UME) in an OSCE setting. Goal of Innovation: We sought to create a clinical reasoning assessment for use in a high-stakes, summative medical student OSCE. Steps taken for Development and Implementation of innovation: A minimum-competency OSCE was administered to medical students following their required clinical clerkships. We developed a tool to assess clinical reasoning of medical students at the conclusion of their required clinical clerkships and deployed it during a minimum-competency OSCE exam given at that time. The highest level of the modified tool represented minimum acceptable performance for examinees. Evaluation of Innovation: The scores and analyses provided evidence to support the use of this tool. Examinees’ performance on clinical reasoning tasks was comparable with their overall performance on the OSCE. The sub-scores for clinical reasoning accurately distinguished successful examinees from those who did not meet the minimum performance level, providing support for the use of the tool in this high stakes setting. Critical Reflection: This tool was found to be useful and defensible to assess medical students’ clinical reasoning. Expanded evidence for generalizability of the tool and its utility in other settings will need to be garnered through multi-center implementation and study.

Jeffrey Siegelman

Lisa Bernstein

Jennifer Goedken

Linda Lewin

Jason Schneider

Martha Ward

Hugh Stoddard

Perspectives on Medical Education

医学教育使命的观点是支持和丰富教育研究人员和临床教育工作者之间的合作学术研究，并推进有关临床教育实践的新知识。荷兰医学教育协会 (NVMO) 的官方期刊。 PERSPECTIVES ON MEDICAL EDUCATION 是一本非盈利性的开放获取期刊，作者提交或发表文章不收取任何费用，并且由于荷兰医学教育协会的赞助，所有文章的全文在发表后立即免费提供。由于其不受限制的在线访问政策，医学教育的观点非常引人注目。医学教育的观点将自己定位于教育研究和临床教育的动态交叉点。虽然健康专业教育领域的其他期刊主要面向教育研究人员或临床教育工作者，但 PERSPECTIVES 将自己定位于这些观点之间的协作界面。这种独特的定位反映了该杂志的使命，即支持和丰富教育研究人员和临床教育工作者之间的合作学术研究，并推进有关临床教育实践的新知识。为了体现这一使命，该期刊既欢迎临床医生、教师和研究人员之间的学术合作产生的原创研究论文，也欢迎为发展社区开展此类合作研究的能力提供资源的论文。该杂志的读者包括研究人员和从业人员：希望探索卫生专业教育的挑战性问题的研究人员和希望推进他们的实践并为自己设想在学术教育创新中发挥协作作用的临床教师。研究人员、临床医生和教育工作者的读者既是国际性的又是跨学科的。该杂志历史悠久。 1982年，该期刊由荷兰医学教育协会创办，为荷兰语期刊（NETHERLANDS JOURNAL OF MEDICAL EDUCATION）。作为荷兰期刊，它推动了荷兰的教育研究和创新。这是荷兰在医学教育方面取得成功的因素之一。 2012年扩大范围，转型为国际英文期刊。该杂志迅速在各个方面国际化：读者、作者、审稿人和编辑委员会成员。编辑委员会成员代表医学教育领域的不同家长学科，例如。临床医生、社会科学家、生物医学科学家、统计学家和语言学家。其中有几位是著名学者。其中三位编辑是医学教育领域被引用次数最多的前十位作者。两名编辑获得了卡罗林斯卡学院研究奖。目前，ERIK DRIESSEN 担任该期刊的总编辑。由于其不受限制的在线访问政策，医学教育的前景非常明显。它由荷兰医学教育协会赞助，并提供免费稿件提交。医学教育观点将自己定位于教育研究和临床教育的动态交叉点。虽然健康专业教育领域的其他期刊主要面向教育研究人员或临床教育工作者，但 PERSPECTIVES 将自己定位于这些观点之间的协作界面。这种独特的定位反映了该杂志的使命，即支持和丰富教育研究人员和临床教育工作者之间的合作学术研究，并推进有关临床教育实践的新知识。为了体现这一使命，该期刊既欢迎临床医生、教师和研究人员之间的学术合作产生的原创研究论文，也欢迎为发展社区开展此类合作研究的能力提供资源的论文。该杂志的读者包括研究人员和从业人员：希望探索卫生专业教育的挑战性问题的研究人员和希望推进他们的实践并为自己设想在学术教育创新中发挥协作作用的临床教师。研究人员、临床医生和教育工作者的读者既是国际性的又是跨学科的。该杂志历史悠久。 1982年，该期刊由荷兰医学教育协会创办，为荷兰语期刊（NETHERLANDS JOURNAL OF MEDICAL EDUCATION）。作为荷兰期刊，它推动了荷兰的教育研究和创新。这是荷兰在医学教育方面取得成功的因素之一。 2012年扩大范围，转型为国际英文期刊。该杂志迅速在各个方面国际化：读者、作者、审稿人和编辑委员会成员。编辑委员会成员代表医学教育领域的不同家长学科，例如。临床医生、社会科学家、生物医学科学家、统计学家和语言学家。其中有几位是著名学者。其中三位编辑是医学教育领域被引用次数最多的前十位作者。两名编辑获得了卡罗林斯卡学院研究奖。目前，ERIK DRIESSEN 担任该期刊的总编辑。由于其不受限制的在线访问政策，医学教育的前景非常明显。它由荷兰医学教育协会赞助，并提供免费的稿件提交。

Perspectives on Medical Education is a journal dedicated to fostering collaboration between educational researchers and clinical educators, aimed at advancing new knowledge in clinical education practices. It is the official publication of the Netherlands Association for Medical Education (NVMO) and operates as a non-profit open-access journal, with no fees for authors to submit or publish articles, and all articles are made freely available immediately upon publication. Due to its unrestricted online access policy, Perspectives on Medical Education is highly regarded in the field of medical education. The journal positions itself at the intersection of educational research and clinical education, welcoming original research papers resulting from academic collaboration among clinicians, teachers, and researchers, as well as papers that provide resources for developing such collaborative research capabilities. Its readership includes researchers interested in exploring challenging issues in health professional education and clinical teachers looking to enhance their practice and envision collaborative roles in academic educational innovation. The readership is both international and interdisciplinary. Founded in 1982 by the Netherlands Association for Medical Education as a Dutch-language journal (NETHERLANDS JOURNAL OF MEDICAL EDUCATION), it has played a significant role in promoting educational research and innovation in the Netherlands. In 2012, the journal transitioned to an international English-language publication, rapidly achieving internationalization among readers, authors, reviewers, and editorial board members. The editorial board members represent various parent disciplines within the field of medical education, including clinicians, social scientists, biomedical scientists, statisticians, and linguists, with several being prominent scholars. Three editors are among the top ten most cited authors in the field of medical education, and two editors have received the Karolinska Institute Research Award. Currently, ERIK DRIESSEN serves as the editor-in-chief of the journal.

《Perspectives on Medical Education》是一本致力于促进教育研究人员与临床教育工作者之间合作的学术期刊，旨在推动临床教育实践的新知识。该期刊是荷兰医学教育协会（NVMO）的官方出版物，属于非盈利开放获取期刊，作者提交或发表文章不收取任何费用，所有文章在发表后立即免费提供。由于其不受限制的在线访问政策，《Perspectives on Medical Education》在医学教育领域中备受瞩目。期刊定位于教育研究与临床教育的交叉点，欢迎临床医生、教师和研究人员之间的学术合作产生的原创研究论文，也欢迎为发展社区提供合作研究能力的资源论文。读者群体包括希望探索卫生专业教育挑战的研究人员，以及希望提升实践并在学术教育创新中发挥协作作用的临床教师。该期刊的读者既是国际性的又是跨学科的。1982年，该期刊由荷兰医学教育协会创办，最初为荷兰语期刊（NETHERLANDS JOURNAL OF MEDICAL EDUCATION），推动了荷兰的教育研究与创新。2012年，期刊转型为国际英文期刊，迅速在读者、作者、审稿人和编辑委员会成员中实现国际化。编辑委员会成员来自医学教育领域的不同学科，包括临床医生、社会科学家、生物医学科学家、统计学家和语言学家，其中多位为著名学者。三位编辑是医学教育领域被引用次数最多的前十位作者，两名编辑获得了卡罗林斯卡学院研究奖。目前，ERIK DRIESSEN担任该期刊的总编辑。

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医学	2
医学, 卫生保健与服务	2
医学, 学科教育	3

Assessment of Clinical Reasoning During a High Stakes Medical Student OSCE

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