Clinical reasoning is a complex and essential competence of the physician’s practice. The vast majority of the instruments approach clinical reasoning from an accuracy point of view. The current study had the goal of developing a new psychometric instrument — the Clinical Reasoning Scale (CRS) — to measure physicians’ perceptions of clinical reasoning. The process of scale development was conducted together with experts from medical education. The initial pool comprises 38 items that were generated based on the literature research about clinical reasoning tasks. The CRS has four dimensions, that are “framing the encounter”, “diagnosis”, “management”, and “self-reflection”. To assess the preliminary validity evidence of the CRS a cross-sectional observational study with a non-probability convenience sample of 23 physicians in Portugal was conducted. The validity evidence based on the internal structure brought promising findings for most of the items (both from a psychometric sensitivity and Rasch measurement perspectives). The internal consistency of the CRS dimensions was satisfactory except for the “framing the encounter” dimension. The validity evidence based on the relations to other variables was satisfactory, since convergent evidence was found with need for cognition, critical thinking dispositions, work-related curiosity, and creativity. Altogether, the preliminary evidence of CRS scale development process is promising. Leaving some possible refinements in terms of scale length and the inclusion or rephrasing of some items from the “framing the encounter” dimensions. The results should be analyzed with caution since the small sample size does not bring the desired statistical power.

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Clinical Reasoning,Clinical Reasoning Scale,psychometrics,validity evidence,psychometric instrument development

This publication is an output of the following project(s):

• Measuring and adapting team-level constructs: Challenges and opportunities