Preliminary report of a Web-based instrument to assess and teach knowledge and clinical thinking to medical student

Gerald H. Stein, Hironobu Tokunaga, Hirotaka Ando, Mikako Obika, Tomoko Miyoshi, Yasuharu Tokuda, Miho Bautista, Hitomi Kataoka, Hidekazu Terasawa

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


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.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalInternational journal of medical education
Publication statusPublished - 2014


  • Testing and educating medical students
  • Web-based learning
  • clinical narrative
  • teaching knowledge and clinical thinking

ASJC Scopus subject areas

  • General Medicine


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