title: Preliminary report of a Web-based instrument to assess and teach knowledge and clinical thinking to medical student.
abstract: OBJECTIVE
  We report the preliminary development of a unique Web-based instrument for assessing and teaching knowledge and developing clinical thinking called the "Sequential Questions and Answers" (SQA) test. Included in this feasibility report are physicians' answers to the Sequential Questions and Answers pre- and posttests and their brief questionnaire replies.
  
  
  METHODS
  The authors refined the SQA test case scenario for content, ease of modifications of case scenarios, test uploading and answer retrieval. Eleven geographically distant physicians evaluated the SQA test, taking the pretest and posttest within two weeks. These physicians completed a brief questionnaire about the SQA test.
  
  
  RESULTS
  Eleven physicians completed the SQA pre- and posttest; all answers were downloaded for analysis. They reported the ease of website login and navigating within the test module together with many helpful suggestions. Their average posttest score gain was 53% (p=0.012).
  
  
  CONCLUSIONS
  We report the successful launch of a unique Web-based instrument referred to as the Sequential Questions and Answers test. This distinctive test combines teaching organization of the clinical narrative into an assessment tool that promotes acquiring medical knowledge and clinical thinking. We successfully demonstrated the feasibility of geographically distant physicians to access the SQA instrument. The physicians' helpful suggestions will be added to future SQA test versions. Medical schools might explore the integration of this multi-language-capable SQA assessment and teaching instrument into their undergraduate medical curriculum.
authors.affiliation: Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA.
authors.forename: Gerald H
authors.initials: GH
authors.lastname: Stein
authors.affiliation: Department of Emergency Medicine, University of Fukui, Faculty of Medical Sciences, Fukui, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Tokunaga
authors.affiliation: Department of Emergency Medicine, University of Fukui, Faculty of Medical Sciences, Fukui, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Ando
authors.affiliation: Centers for Graduate Medical Education, Okayama, Okayama University Graduate School of Medicine, Okayama, Japan.
authors.forename: Mikako
authors.initials: M
authors.lastname: Obika
authors.affiliation: Department of Medical Education and Primary Care, Okayama University School of Medicine, Okayama, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Miyoshi
authors.affiliation: Mito Medical Center, University of Tsukuba Hospital, Institute of Clinical Medic ine, University of Tsukuba, Ibaraki, Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Tokuda
authors.affiliation: Department of Aging and Geriatrics, University of Florida College of Medicine, Gainesville, Florida, USA.
authors.forename: Miho
authors.initials: M
authors.lastname: Bautista
authors.affiliation: Department of Medical Education and Primary Care, Okayama University School of Medicine, Okayama, Japan.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Kataoka
authors.affiliation: Department of Emergency Medicine, University of Fukui, Faculty of Medical Sciences, Fukui, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Terasawa
mesh_terms: D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D005240:Feasibility Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D010820:Physicians; D013337:Students, Medical; D013850:Thinking
keywords: Testing and educating medical students; Web-based learning; clinical narrative; teaching knowledge and clinical thinking