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A Medical Student Inquiry Behavior Assessment Tool

Development and Validity Evidence

Brondfield, Sam, MD; Boscardin, Christy, PhD; Strewler, Gordon, MD; Hyland, Katherine, PhD; Oakes, Scott A., MD; Nishimura, Holly; Crawford, Jenny, MA, MPH; Hauer, Karen E., MD, PhD

doi: 10.1097/ACM.0000000000002520
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Purpose The University of California, San Francisco (UCSF) School of Medicine’s Bridges curriculum is designed to teach inquiry: the process of approaching problems with curiosity, challenging current concepts, and creating new knowledge. The authors aimed to develop and gather validity evidence for a tool to guide development of medical student inquiry behaviors in small groups.

Method The authors reviewed the literature to identify inquiry behaviors, verified findings with an expert focus group, and synthesized the results into 40 behaviors. In a modified two-round Delphi survey in 2016, faculty and students rated the behaviors for inclusion in the tool. Feedback from cognitive interviews and a pilot helped refine the tool. In 2016–2017, the authors implemented the final tool for 152 first-year UCSF medical students in inquiry small groups as a faculty assessment and a student self-assessment each quarter.

Results The two-round response rate was 77% (36/47). Five behaviors were selected for inclusion in the tool: select relevant questions to pursue; justify explanations with evidence; critically evaluate his/her explanation in light of alternative possibilities; allow for the possibility that his/her own knowledge may not be completely correct; and collaborate well with peers. During implementation, faculty and student scores increased on most items, indicating skills development over time. Content, response process, internal structure, and consequential validity evidence is presented.

Conclusions The tool’s five items are observable, measurable core inquiry behaviors. The tool is ready for use by small-group facilitators within inquiry-based curricula to promote student self-assessment and guide feedback to students.

S. Brondfield was internal medicine chief resident at the time of the study and is currently chief hematology/oncology fellow, Department of Medicine, University of California, San Francisco, San Francisco, California.

C. Boscardin is associate professor, Department of Medicine, University of California, San Francisco, San Francisco, California.

G. Strewler is professor, Department of Medicine, University of California, San Francisco, San Francisco, California.

K. Hyland is professor, Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, California.

S.A. Oakes is professor, Department of Pathology, University of California, San Francisco, San Francisco, California.

H. Nishimura was research analyst, Office of Research and Development in Medical Education, University of California, San Francisco, San Francisco, California, at the time of the study.

J. Crawford was curriculum manager, Office of the Dean, University of California, San Francisco, San Francisco, California, at the time of the study.

K.E. Hauer is professor, Department of Medicine, University of California, San Francisco, San Francisco, California.

Funding/Support: No funding to disclose. Internal discretionary funds were used to provide gift cards to the modified Delphi study student participants.

Other disclosures: None reported.

Ethical approval: The UCSF Institutional Review Board approved this study as exempt.

Previous presentations: Previously presented at the 2017 Western Group on Educational Affairs (WGEA) meeting; February 2017; Salt Lake City, Utah.

Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A613.

Correspondence should be addressed to Sam Brondfield, 505 Parnassus Ave., UCSF Hematology Oncology Fellowship, UCSF Box 1270, San Francisco, CA 94143-1270; telephone: (415) 885-7276; e-mail: sam.brondfield@ucsf.edu.

© 2019 by the Association of American Medical Colleges