Friday 8 November - Workshop Sessions I (EBMA)
13:15-15:00, Room 01.11, Ground Floor 

Assessing Clinical Reasoning at the ‘Shows How’ Level

* Harish Thampy, Heidi Northover, Serena Tolhurst-Cleaver
* Corresponding author: Harish Thampy, University of Manchester, United Kingdom
harish.thampy@manchester.ac.uk 

Background
Clinical reasoning is a core component of clinical competency that is used in all patient encounters from the simple through to complex presentations. It involves synthesis of myriad clinical and investigative data, to generate and prioritize an appropriate differential diagnosis and inform safe and targeted management plans. Furthermore, clinicians should be aware of a range of cognitive biases that can derail diagnostic and therapeutic decision making. Although there also exists a range of literature exploring how best educators can assess clinical reasoning abilities, these have largely focussed on written assessments that assess the lower levels of ‘knows’ and ‘knows how’ of Miller’s pyramid of clinical competence.  

Summary of Work  
This workshop focuses on the ‘Shows How’ level of assessment and draws upon existing evidence and expert opinion to review the range of strategies and methods that allow effective assessment of reasoning ability through the Objective Structured Clinical Examination assessment format.  

Discussion  
This workshop uses interactive tasks and presentations to allow participants to learn, share and create ideas relating to clinical reasoning assessment in the OSCE setting. We will explore ways to overcome the challenge of attempting to assess what is largely an internal mental process that is not directly observable to the examiner. Design strategies and modifications to traditional OSCE station formats will be explored with sharing of advice and lessons learnt from the presenters’ own institution.

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