IDEA Method for Assessing Clinical Reasoning

Feedback and assessment by supervising physicians are vital for students to develop clinical skills and to ensure clinical competence. One important skill that students must develop prior to beginning residency is the proper documentation of a history and physical. Students regularly perform this task, but supervising physicians often have differing standards on what ideal documentation should include. The IDEA (interpretive summary, differential diagnosis, explanation of reasoning for most likely diagnosis, and alternative diagnoses) format was developed for medical students to demonstrate their clinical reasoning in their new patient admission notes. The IDEA assessment tool is a validated 15-item instrument used by evaluators to rate student reporting, diagnostic reasoning, and decision-making skills. As with any assessment tool, rater training is necessary to ensure the reliability of the IDEA assessment tool. We will present the experience of two institutions who have used the IDEA assessment tool to assess student documentation and clinical reasoning. We will describe the IDEA assessment tool and the faculty development process that we have used for rater training. We will provide resources to help incorporate the IDEA assessment tool into your clerkship.