Teaching and Assessing Higher-order Cognitive Skills in Fellowship Training

Abstract

Section snippets

Background on Cognitive Skill Measurement

A hierarchical order of cognitive skills widely used as a framework for categorizing education milestones was first described in 1956 by Benjamin Bloom. These cognitive skills were classified by increasing complexity with the most basic being knowledge, followed by comprehension, application, analysis, synthesis, and assessment.¹ This was revised in 2021 with the lower order cognitive skills being classified as remember, understand, and higher-order cognitive skills (HOCS) as apply, analyze,

Existing Tools, Their Limitations, and Mechanisms for Optimization

Although not necessarily packaged as such, it is valuable to recognize existing teaching practices that already serve as training tools for the development and assessment of HOCS.

Simulation and the Incorporation of Artificial Intelligence

The ACGME recommends simulation training as one of the Gastroenterology training program requirements.⁶ Simulation is beneficial for teaching novice and experienced gastroenterologists who are expanding their skill set in a low-risk environment.³⁹ However, the majority of simulation has focused on development of technical endoscopy skills. Cognitive skills and clinical reasoning can be assessed and developed with simulation through the use of simulated patients and clinical scenarios.^23,40,41