title: Do short cases elicit different thinking processes than factual knowledge questions do?
abstract: OBJECTIVE
  To assess whether case-based questions elicit different thinking processes from factual knowledge-based questions.
  
  
  METHODS
  20 general practitioners (GPs) and 20 students solved case-based questions and matched factual knowledge-based questions while thinking aloud. Verbatim protocols were analysed. Five indicators were defined: extent of protocols; immediate responses; re-reading of information given in the stem or case after the question had been read; order of re-reading information, and type of consideration, i.e. 'true-false' type or 'vector', that is, a deliberation which has a magnitude and a direction.
  
  
  RESULTS
  Cases elicited longer protocols than factual knowledge questions. Students re-read more given information than GPs. GPs gave an immediate response on twice as many occasions as students. GPs re-ordered the case information, whereas students re-read the information in the order it was presented. This ordering difference was not found in the factual knowledge questions. Factual knowledge questions mainly led to 'true-false' considerations, whereas cases elicited mainly 'vector' considerations.
  
  
  CONCLUSIONS
  Short case-based questions lead to thinking processes which represent problem-solving ability better than those elicited by factual knowledge questions.
authors.affiliation: Department of Educational Development and Research, University of Maastricht, The Netherlands.
authors.forename: L W
authors.initials: LW
authors.lastname: Schuwirth
authors.forename: M M
authors.initials: MM
authors.lastname: Verheggen
authors.forename: C P
authors.initials: CP
authors.lastname: van der Vleuten
authors.forename: H P
authors.initials: HP
authors.lastname: Boshuizen
authors.forename: G J
authors.initials: GJ
authors.lastname: Dinant
mesh_terms: D004501:Education, Medical / Q000379:methods*; D004521:Educational Measurement / Q000379:methods*; D005194:Family Practice / Q000193:education*; D006801:Humans; D009426:Netherlands; D011340:Problem Solving; D013850:Thinking