In an effort to better align item development to goals of assessing higher-order tasks and decision making, complex decision trees were developed to follow clinical reasoning scripts and used as models on which multiple-choice questions could be built. This approach is compatible with best-practice assessment frameworks like Evidence Centered…

Context specificity, or the variation in a participant's performance from one case, or situation, to the next, is a recognized problem in medical education. However, studies have not explored the potential reasons for context specificity in experts using the lens of situated cognition and cognitive load theories (CLT). Using these theories, we…