Development of cognitive processing and judgments of knowledge in medical students: Analysis of progress test results.
BACKGROUND
Beside acquiring knowledge, medical students should also develop the ability to apply and reflect on it, requiring higher-order cognitive processing. Ideally, students should have reached higher-order cognitive processing when they enter the clinical program. Whether this is the case, is unknown. We investigated students' cognitive processing, and awareness of their knowledge during medical school.


METHODS
Data were gathered from 347 first-year preclinical and 196 first-year clinical students concerning the 2008 and 2011 Dutch progress tests. Questions were classified based upon Bloom's taxonomy: "simple questions" requiring lower and "vignette questions" requiring higher-order cognitive processing. Subsequently, we compared students' performance and awareness of their knowledge in 2008 to that in 2011 for each question type.


RESULTS
Students' performance on each type of question increased as students progressed. Preclinical and first-year clinical students performed better on simple questions than on vignette questions. Third-year clinical students performed better on vignette questions than on simple questions. The accuracy of students' judgment of knowledge decreased over time.


CONCLUSIONS
The progress test is a useful tool to assess students' cognitive processing and awareness of their knowledge. At the end of medical school, students achieved higher-order cognitive processing but their awareness of their knowledge had decreased.
a Center for Education Development and Research in Health Professions (CEDAR), University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.
Dario
D
Cecilio-Fernandes
b Center for Dentistry and Oral Hygiene, Department of Public and Individual Oral Health, University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.
Wouter
W
Kerdijk
a Center for Education Development and Research in Health Professions (CEDAR), University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.
A D Debbie C
AD
Jaarsma
a Center for Education Development and Research in Health Professions (CEDAR), University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.|c Department of Cardiology, University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.
René A
RA
Tio
D000066491:Clinical Decision-Making / Q000379:methods*; D003071:Cognition; D004501:Education, Medical / Q000379:methods; D004521:Educational Measurement / Q000379:methods; D006801:Humans; D007600:Judgment; D019359:Knowledge; D013337:Students, Medical / Q000523:psychology*