Use of an educational taxonomy for evaluation of cognitive performance
Abstract
Complex cognitive processes, such as interpretation of information and problem-solving, form a critical part of medical practice; therefore, the aims of many educational programs include teaching these processes. However, systematic evaluation of students' interpretation of information or problem-solving may be difficult. To determine whether objective test items could measure cognitive processes more complex than recall of isolated facts, the committee of the American Academy of Orthopaedic Surgeons preparing the Orthopaedic In-Training Examination classified test items into three taxonomic levels according to the cognitive process required to answer the item: recall or recognition, interpretation, and problem-solving. Orthopedic residents from 20 universities took the examination and classified items according to the cognitive process they believed they used to answer the questions. Two methods of analysis showed that residents agreed closely with the taxonomic levels assigned by the committee, suggesting that items did test the cognitive process they were designed to measure and that objective assessment of complex cognitive processes is practical and potentially very useful in medical education.
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Questions were classified by cognitive taxonomy based on Buckwalter et al: Taxonomy 1 recall and recognition of facts, Taxonomy 2 interpretation of data, images, or diagnostic studies, and Taxonomy 3 complex clinical reasoning, problem-solving, and management decisions.
“Additionally, questions were classified by cognitive taxonomy based on established medical education frameworks defined by Buckwalter et al: Taxonomy 1 (T1): Recall and recognition of facts, Taxonomy 2 (T2): Interpretation of data, images, or diagnostic studies, and Taxonomy 3 (T3): Complex clinical reasoning, problem-solving, and management decisions (Buckwalter et al. 1981).”
From Evidence on Demand: OpenEvidence versus Established LLMs on the Orthopaedic In-Training Examination (2026) · cites this paper as Buckwalter et al. 1981
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The Impact of Classroom Evaluation Practices on Students
Crooks, T. J. (1988) · Review of Educational Research · doi:10.3102/00346543058004438 · Cited by 1,369 · see citing works
Palmer, E. J., & Devitt, P. G. (2007) · BMC Medical Education · doi:10.1186/1472-6920-7-49 · Cited by 294 · see citing works
Evidence on Demand: OpenEvidence versus Established LLMs on the Orthopaedic In-Training Examination
Khan, A. A., Lalvani, S. S., Pourarbab, S., Hyeamang, L. J., Lew, R. M., Hussain, Z. B., Nicholson, G. P., & Garrigues, G. E. (2026) · Journal of Orthopaedic Experience & Innovation · doi:10.60118/001c.162882
- Authors
- Buckwalter, J. A., Schumacher, R., Albright, J. P., & Cooper, R. R.
- Venue
- Academic Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 1981-02
- Volume
- 56
- Issue
- 2
- Pages
- 115-21
- ISSN
- 1040-2446 (ISSN-L)
- OpenAlex
- W1991227778
- Cited by
- 108
- References
- 0
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 5 · 2023: 11 · 2022: 4 · 2021: 4 · 2020: 8 · 2019: 3 · 2018: 2 · 2017: 6 · 2016: 13 · 2015: 6 · 2014: 5 · 2013: 1 · 2012: 6
- FWCI
- 1.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Academic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Social Sciences › Education › Educational Assessment and Pedagogy
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Keywords
- educational taxonomy, problem solving, information interpretation, recall and recognition, Orthopaedic In-Training Examination, orthopaedic residents, medical education assessment
- MeSH terms
- Cognition, Education, Medical, Educational Measurement, Humans, Internship and Residency, Orthopedics, Problem Solving, Mental Recall
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