Comparison between key feature exam and multiple choice questions in internal medicine department of Shiraz University of medical sciences

Introduction: Clinical reasoning skills play a major role in the ability of doctors to make
diagnosis and reach treatment decisions. This study is a report of use an innovative
assessment tool: key feature exam, in problem solving domain. The main purpose of this
study was to compare key feature results with routine multiple choice questions in internal
medicine department.
Methods: Final year internal medicine students (n=100) of Shiraz medical school
participated in this study. They implemented in multiple choice questions exam; then
participated in key feature exam. Reliability, item’s difficulty level and item’s total
correlation as discriminative index, about key feature exam have been considered.
Results: The maximum, minimum and mean scores of the students in key feature exam
were 23.7, 41.2 and 30.91, respectively. The reliability of key feature exam was 0.68
(chronbach’s alpha). The item’s difficulty level scores were between 0.3-0.8 in all key
feature questions and item’s total correlation was 0.16-0.54. Correlation between key feature
exam and multiple choice questions exam was 0.25 (P<0.05).
Conclusion: The results of the present study suggest that key feature examination may be a
better method for evaluating clinical reasoning skills of medical students.