Acad Med. 2007 Oct;82(10):S40-3. doi: 10.1097/ACM.0b013e31813ffda4.

Reasoning when it counts: students' rationales for action on a professionalism exam.

Academic medicine : journal of the Association of American Medical Colleges

Shiphra R Ginsburg, Glenn Regehr, Maria Mylopoulos

PMID: 17895688 DOI: 10.1097/ACM.0b013e31813ffda4

Abstract

BACKGROUND: Previous research explored students' reasoning in the face of professional dilemmas, using interviews in response to videotaped scenarios. This study determined the effects of a change in context (to a written exam) and format (video versus text scenarios) on students' response patterns.

METHOD: Fifty-three students were randomized to videotaped or text-based scenarios in the context of a mock written exam. Responses were coded by two raters.

RESULTS: Interrater reliability was high (kappa = 0.872). There were no differences in response patterns between the video and text groups. When compared with the interview setting, students' exam responses showed a shift towards more "acceptable" rationales for action; however, they still considered implications for themselves.

CONCLUSIONS: This shift in responses indicates that students took the exam seriously. Their continued reference to implications for themselves might therefore reflect a sense that their status as students makes these considerations legitimate; alternatively, students' interpretation of altruism may be different than what the profession avows.

MeSH terms

• Clinical Competence / standards
• Education, Medical, Undergraduate / methods
• Educational Measurement / methods
• Humans
• Motivation*
• Problem Solving*
• Students, Medical / psychology
• Surveys and Questionnaires
• Video Recording

Publication Types

• Journal Article
• Research Support, Non-U.S. Gov't