Semantic competency as a marker of clinical reasoning performance

Purpose: This study sought to explore the relationship between semantic competence (or dyscompetence) displayed during think alouds performed by resident and attending physicians and clinical reasoning performance.

Methods: Internal medicine resident physicians and practicing internists participated in “think-alouds” performed after watching videos of typical presentations of common diseases in internal medicine. The think-alouds were evaluated for the presence of semantic competence and dyscompetence and these results were correlated with clinical reasoning performance. 

Results: We found that the length of think-aloud was negatively correlated with clinical reasoning performance. Beyond this finding, however, we did not find any other significant correlations between semantic competence or dyscompetence and clinical reasoning performance.

Conclusion: While this study did not produce the previously hypothesized findings of correlation between semantic competence and clinical reasoning performance, we discuss the possible implications and areas of future study regarding the relationship between semantic competency and clinical reasoning performance.

Methods
Data was collected by review of transcripts from think-alouds performed by participants in the study. Data was coded by a group of authors using the coding rules included in the paper, with results included on the spreadsheet.