“The Physician's Statement”: A novel test item strategy for medical education

We introduce a novel test item strategy that requires higher‐order thought processes. In this format, students first receive a clinical vignette. Then a physician makes a higher‐order statement presumably based on the data contained within a clinical vignette. This statement may propose a diagnosis, a treatment, the physiological basis for a clinical condition, etc. Students then analyze the vignette and this physician's statement, in a two‐question format. In the first question, students confirm whether the statement is: a) correct, b) incorrect, c) logical but requires more information to adequately support, d) illogical but requires more information to definitively refute, or e) unrelated to available data; only guessing. In the second question, students suggest how to support or refute the statement by choosing either: a) no additional information is required, b) or c) as two options that could provide support for the statement, or d) or e) as two options to refute the statement. Requiring students to analyze a physician's third‐order statement and then justify their decisions takes this assessment format a level beyond that of standard scenario style questions. This format also requires students to apply basic science information to a clinical case in a manner that does not appear contrived and which promotes classroom discussions. This format may be equally useful in clinical training.