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Reflective Judgment in Medicine – Developing the Reasoning about Medical Issues Test

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posted on 01.08.2019, 00:00 authored by Goetz Fabry
There is growing awareness that epistemic cognition is a very important conceptual framework – not only but especially in medicine – in order to understand how individuals deal with ill-defined problems. Assessing epistemic cognition quantitatively, however, has proven to be difficult and there is no standard instrument for this purpose to date. Against this background we developed a questionnaire to capture epistemic cognition as outlined in the Reflective Judgment Model. We chose this particular model because it not only explicitly targets how individuals deal with ill-defined problems but also because it is a developmental model delineating how epistemic cognition evolves depending on age, education, experience etc. Our initial questionnaire comprised 31 items to be rated on a five-point category rating scale. Based on data from a cohort of 313 first and 189 third year medical students we performed confirmatory and exploratory factor analyses. The latter yielded a three-factor solution including 24 of the 31 items that resembled the macrostructure of the Reflective Judgment Model. However, the internal consistency of the scales was rather low (.57 / .65 / .67) indicating that further effort is needed to improve the instrument before it can be used for educational and diagnostic purposes.



Schwartz, Alan


Schwartz, Alan


Medical Education

Degree Grantor

University of Illinois at Chicago

Degree Level


Degree name

MHPE, Master of Health Professions Education

Committee Member

Edison, Marcia I. Tekian, Ara S.

Submitted date

August 2019

Thesis type




Issue date


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