Psychometric characteristics of clinical reasoning problems (CRPs) and its correlation with routine multiple choice question (MCQ) in cardiology department

Introduction: Clinical reasoning is one of the most importantskills in the process of training a medical student to become anefficient physician. Assessment of the reasoning skills in a medicalschool program is important to direct students’ learning. One ofthe tests for measuring the clinical reasoning ability is ClinicalReasoning Problems (CRPs). The major aim of this study is tomeasure psychometric properties of CRPs and define correlationbetween this test and routine MCQ in cardiology department ofShiraz medical school.Methods: This study was a descriptive study conducted ontotal cardiology residents of Shiraz Medical School. The studypopulation consists of 40 residents in 2014. The routine CRPsand the MCQ tests was designed based on similar objectives andwere carried out simultaneously. Reliability, item difficulty, itemdiscrimination, and correlation between each item and the totalscore of CRPs were all measured by Excel and SPSS softwarefor checking psycometeric CRPs test. Furthermore, we calculatedthe correlation between CRPs test and MCQ test. The meandifferences of CRPs test score between residents’ academic year[second, third and fourth year] were also evaluated by Analysis ofvariances test (One Way ANOVA) using SPSS software (version20)(α=0.05).Results: The mean and standard deviation of score in CRPs was10.19±3.39 out of 20; in MCQ, it was 13.15±3.81 out of 20. Itemdifficulty was in the range of 0.27-0.72; item discrimination was0.30-0.75 with question No.3 being the exception (that was 0.24).The correlation between each item and the total score of CRP was0.26-0.87; the correlation between CRPs test and MCQ test was0.68 (p<0.001). The reliability of the CRPs was 0.72 as calculatedby using Cronbach’s alpha. The mean score of CRPs was differentamong residents based on their academic year and this differencewas statistically significant (p<0.001).Conclusion: The results of this present investigation revealed thatCRPs could be reliable test for measuring clinical reasoning inresidents. It can be included in cardiology residency assessmentprograms.Keywords: Cardiovascular, Clinical reasoning, Reliability