Reliability and construct validity of some cognitive measures of clinical reasoning

Abstract

The past few years have seen a growing interest in understanding clinical reasoning processes by using the research methods of cognitive psychology. Nevertheless, a gap remains between the basic research methods and the application of these methods as evaluative instruments. The present research applied standard psychometric “yardsticks"—reliability and construct validity—to several cognitive measures of recall and perception used in previous studies. The cognitive measures were compared to measures of clinical performance derived from encounters with simulated patients and to conventional measures of knowledge based on multiple‐choice questions and modified essay questions. The cognitive measures demonstrated reliability comparable to that of the conventional tests and considerably exceeding that of the clinical performance measures. Validity coefficients were comparable for all the measures. A calculation of reliability per unit of testing time indicated that the cognitive measures were more efficient than the other measures. These results provide at least a preliminary indication that the gap between cognitive measures and conventional measures of clinical performance can be narrowed.