Zeitschrift für Hochschuldidaktik Nr. 3/1997
Educating Doctors for the 21st Century
Lambert W.T. Schuwirth, C.P.M. van der Vleuten and M. Verheggen (Maastricht, The Netherlands)
Assessment of Medical Problem-solving - What can be Learned from Recent History?
Summary
In the last 4-5 decades many developments in the assessment of medical problem-solving have occured. In the 1940/ 50s the focus of attention was on the increasing reliability of examinations by increasing the objectivity (e.g. by using more written examinations) and by adding structure (e.g. by using multiple-choice questions). These examinations proved to be highly reliable, though concerns arose with respect to the validity. In the 1960/70s more emphasis was placed on using long simulations in examinations to increase the validity. Although originally these simulations seemed to be well fit for testing problem solving, they suffered from serious flaws concerning validity and reliability. For this reason these examination types have been abandonned in all major testing institutes. Modern testing methods use short cases with only a limited number of questions. These questions focus on essential decisions only thus making it possible to ask the key-elements of many different cases in a test, thus optimizing reliability and validity.
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