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Biomedical subjects

L W Schuwirth

Publications and source records attributed to L W Schuwirth.

5 recordsLinked to original sources
PubMed2001

Do short cases elicit different thinking processes than factual knowledge questions do?

PURPOSE: To assess whether case-based questions elicit different thinking processes from factual knowledge-based questions. METHOD: 20 general practitioners (GPs) and 20 students solved case-based questions and matched factual knowledge-based questions while thinking aloud. Verbatim protocols were analysed. Five indicators were defined: extent of protocols; immediate responses; re-reading of information given in the stem or case after the question had been read; order of re-reading information, and type of consideration, i.e. 'true-false' type or 'vector', that is, a deliberation which has a magnitude and a direction. RESULTS: Cases elicited longer protocols than factual knowledge questions. Students re-read more given information than GPs. GPs gave an immediate response on twice as many occasions as students. GPs re-ordered the case information, whereas students re-read the information in the order it was presented. This ordering difference was not found in the factual knowledge questions. Factual knowledge questions mainly led to 'true-false' considerations, whereas cases elicited mainly 'vector' considerations. CONCLUSION: Short case-based questions lead to thinking processes which represent problem-solving ability better than those elicited by factual knowledge questions.

Education, Medical↗
PubMed1996

A closer look at cueing effects in multiple-choice questions.

This study investigates the cueing effect occurring in multiple choice questions. Two parallel tests with matching contents were administered. By means of a computer program, examinees of different training levels and professional expertise were presented the same set of 35 cases (derived from patient problems in general practice) twice. The first time the cases were linked to open-ended questions; the second time they were linked to multiple choice questions. The examinees consisted of 75 medical students from three different years of training, 25 residents in training for general practice and 25 experienced general practitioners. Across groups, total test scores reflected a difference in mean scores on both formats, and a high inter-test correlation. Within each level of expertise, differences in mean scores and high correlations were also found. The data were further explored per group of examinees. Two types of cueing effects were found: positive cueing (examinees were cued towards the correct answer) and negative cueing (examinees were cued towards an incorrect answer). These effects were found at all levels of expertise and in almost all items. However, both effects decline with increasing level of expertise. Positive cueing mainly occurs in difficult items, whereas negative cueing mainly occurs in easy items.

Adult↗
PubMed1996

Computerized long-menu questions as an alternative to open-ended questions in computerized assessment.

To optimally avoid cueing effects and computer scoring problems in computerized examinations a computerized long-menu question (CLM) was developed. This question type was compared to open-ended questions in one treatment group and to multiple-choice questions in another treatment group. Also, scores were compared to self-perceived computer anxiety of the participants. CLMs yield comparable scores to open-ended questions, but the scores differ significantly from those on multiple-choice tests. Correlations in the first comparison (CLMs with multiple-choice) were higher than those in the second camparison (CLMs with open-ended questions). The amount of positive and negative cueing was considerably higher in the first than in the second comparison. Response times of CLMs were higher than those of multiple-choice questions and open-ended questions, differing significantly from both. Computer anxiety did not influence the mean scores in either comparison. Therefore, in computerized testing CLMs seem to offer an acceptable replacement of open-ended questions.

Adult↗
PubMed1995

Assessing clinical competence: recognition of case descriptions of rheumatic diseases by general practitioners.

The objective of this study was to detect strengths and weaknesses in the diagnosis of rheumatic diseases by general practitioners in order to set up post-graduate training accordingly and to assess whether open-ended questions give results comparable with multiple choice-type questions. Fifty-one general practitioners were given eight written cases: rheumatoid arthritis (RA), ankylosing spondylitis (AS), reactive arthritis, psoriatic arthritis (PsA), systemic lupus erythematosus (SLE), gout, polymyalgia rheumatica and pseudogout. Only signs and symptoms were provided. All cases were derived from real patients with a definite diagnosis. Each case was presented in both types of question formats. The cases were also presented to 23 rheumatologists. We found that in the open-ended question format 57.1% of the general practitioners gave the correct answers. Cases of RA, AS, gout and PsA were correctly diagnosed by > 70% of the general practitioners. Cases of polymyalgia rheumatica and reactive arthritis were correctly diagnosed by 55 and 39% of the general practitioners, respectively. The cases of pseudogout and SLE were correctly diagnosed by less than 11% of the general practitioners. Fifty-two per cent of the general practitioners gave the correct answers to the multiple choice-type questions. There was no statistical difference in the correct answers between the open-ended questions and the multiple choice-type questions. We concluded that assuming generalization of the results, training of general practitioners should include polymyalgia rheumatica, reactive arthritis, SLE and pseudogout.

Clinical Competence↗