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Medical Teacher Volume 35, 2013 - Issue 9
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Does the think-aloud protocol reflect thinking? Exploring functional neuroimaging differences with thinking (answering multiple choice questions) versus thinking aloud

Steven J. DurningUniformed Services University of the Health Sciences, USA; STEVEN J. DURNING, MD, Phd, is Professor of Medicine and Pathology who directs an introduction to clinical reasoning course and co-directs the Long Term Career Outcome Study at USU.Correspondence[email protected]
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Anthony R. Artino Jr.Uniformed Services University of the Health Sciences, USA; ANTHONY R. ARTINO, Jr., Phd is Associate Professor of Medicine and Preventive Medicine & Biometrics. He has a PhD in educational psychology and co-directs the Long Term Career Outcome Study at USU.
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Thomas J. BeckmanMayo Clinic, USA; THOMAS J. BECKMAN, MD is Professor of Medicine and Medical Education at the Mayo Clinic.
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John GranerUniformed Services University of the Health Sciences, USA; JOHN GRANER, Phd is an fMRI analyst at the Uniformed Services University.
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Cees van der VleutenMaastricht University, the Netherlands; CEES VAN DER VLEUTEN, Phd is Professor of Education at Maastricht University.
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Eric HolmboeAmerican Board of Internal Medicine, USA; ERIC HOLMBOE is the Senior Vice President and Chief Medical Officer for the American Board of Internal Medicine.
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Lambert SchuwirthFlinders University, Australia; LAMBERT SCHUWIRTH, MD, Phd is Professor of Medical Education at Flinders University.
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Pages 720-726 | Published online: 27 Jun 2013

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W. Rainey Johnson, Anthony R. Artino$suffix/text()$suffix/text() & Steven J. Durning. (2023) Using the think aloud protocol in health professions education: an interview method for exploring thought processes: AMEE Guide No. 151. Medical Teacher 45:9, pages 937-948.
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Serkan Toy, Dana D Huh, Joshua Materi, Julie Nanavati & Deborah A. Schwengel. (2022) Use of neuroimaging to measure neurocognitive engagement in health professions education: a scoping review. Medical Education Online 27:1.
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Dominique S. Hammonds & Mark J. Schwarze. (2019) Toward Oral Assessment in Counselor Education: Practice-Based Measurement of Competence in Pre-Practicum Experiences. Journal of Creativity in Mental Health 14:4, pages 532-548.
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Alyssa Power, Jean-Francois Lemay & Suzette Cooke. (2017) Justify Your Answer: The Role of Written Think Aloud in Script Concordance Testing. Teaching and Learning in Medicine 29:1, pages 59-67.
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Articles from other publishers (31)

Syeda Fabeha Husain, Nixi Wang, Roger S. McIntyre, Bach X. Tran, Thao Phuong Nguyen, Linh Gia Vu, Giang Thu Vu, Roger C. Ho & Cyrus S. Ho. (2023) Functional near-infrared spectroscopy of medical students answering various item types. Frontiers in Psychology 14.
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Ellen Haustein & Peter C. Lorson. (2022) Transparency of local government financial statements: Analyzing citizens’ perceptions. Financial Accountability & Management 39:2, pages 375-393.
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Josepha Kuhn, Silvia Mamede, Pieter van den Berg, Laura Zwaan, Petra van Peet, Patrick Bindels & Tamara van Gog. (2022) Learning deliberate reflection in medical diagnosis: does learning-by-teaching help?. Advances in Health Sciences Education 28:1, pages 13-26.
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Stephen Isbel, Ted Brown, Mong-Lin Yu, Thomas Bevitt, Craig Greber & Anne-Maree Caine. 2023. Clinical Education for the Health Professions. Clinical Education for the Health Professions 1277 1301 .
Anke Sambeth, Steven Durning, Minna Huotilainen & Anique de Bruin. 2022. Researching Medical Education. Researching Medical Education 187 195 .
Mireille Gagnon-Roy, Nathalie Bier, Stéphanie Boulé-Riley, Heidi Keurentjes, Priscilla Lam Wai Shun, Guylaine Le Dorze & Carolina Bottari. (2021) Providing Verbal Assistance When Assessing Individuals Living with a Traumatic Brain Injury. Canadian Journal of Occupational Therapy 88:4, pages 306-318.
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Stephen Isbel, Ted Brown, Mong-Lin Yu, Thomas Bevitt, Craig Greber & Anne-Maree Caine. 2020. Clinical Education for the Health Professions. Clinical Education for the Health Professions 1 25 .
Klodiana Kolomitro, Leslie W. MacKenzie, Mackenzie Lockridge & Diandra Clohosey. (2020) Problem‐solving strategies used in anatomical multiple‐choice questions . Health Science Reports 3:4.
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Elizabeth W. PingreeKathleen HuthBeth D. HarperMari M. NakamuraCarolyn H. MarcusChristine C. ChestonDaniel J. SchumacherAriel S. Winn. (2020) Encouraging Entrustment: A Qualitative Study of Resident Behaviors That Promote Entrustment. Academic Medicine 95:11, pages 1718-1725.
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Divya Ramani, Michael Soh, Jerusalem Merkebu, Steven J. Durning, Alexis Battista, Elexis McBee, Temple Ratcliffe & Abigail Konopasky. (2020) Examining the patterns of uncertainty across clinical reasoning tasks: effects of contextual factors on the clinical reasoning process. Diagnosis 7:3, pages 299-305.
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Abigail Konopasky, Steven J. Durning, Alexis Battista, Anthony R. ArtinoJrJr, Divya Ramani, Zachary A. Haynes, Catherine Woodard & Dario Torre. (2020) Challenges in mitigating context specificity in clinical reasoning: a report and reflection. Diagnosis 7:3, pages 291-297.
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Abigail Konopasky, Steven J. Durning, Anthony R. Artino, Divya Ramani & Alexis Battista. (2020) The Linguistic Effects of Context Specificity: Exploring Affect, Cognitive Processing, and Agency in Physicians’ Think-Aloud Reflections. Diagnosis 7:3, pages 273-280.
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Samuel Giles, David Fletcher, Rachel Arnold, Arabella Ashfield & Joanna Harrison. (2020) Measuring Well-Being in Sport Performers: Where are We Now and How do we Progress?. Sports Medicine 50:7, pages 1255-1270.
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Thora Tenbrink. 2020. Cognitive Discourse Analysis. Cognitive Discourse Analysis.
Megan Ohmer, Steven J. Durning, Walter Kucera, Matthew Nealeigh, Sarah Ordway, Thomas Mellor, Jeffery Mikita, Anna Howle, Sarah Krajnik, Abigail Konopasky, Divya Ramani & Alexis Battista. (2019) Clinical Reasoning in the Ward Setting: A Rapid Response Scenario for Residents and Attendings. MedEdPORTAL.
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Caroline Vass, Dan Rigby & Katherine Payne. (2018) “I Was Trying to Do the Maths”: Exploring the Impact of Risk Communication in Discrete Choice Experiments. The Patient - Patient-Centered Outcomes Research 12:1, pages 113-123.
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Luke T. Surry, Dario Torre, Robert L. Trowbridge & Steven J. Durning. (2018) A mixed-methods exploration of cognitive dispositions to respond and clinical reasoning errors with multiple choice questions. BMC Medical Education 18:1.
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Alexis Battista, Abigail Konopasky, Divya Ramani, Megan Ohmer, Jeffrey Mikita, Anna Howle, Sarah Krajnik, Dario Torre & Steven J. Durning. (2018) Clinical Reasoning in the Primary Care Setting: Two Scenario-Based Simulations for Residents and Attendings. MedEdPORTAL.
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Lawrence Baines & Anastasia Wickham. (2018) Teaching in Multilingual Schools. English Journal 107:6, pages 14-19.
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David J. Hughes. 2018. The Wiley Handbook of Psychometric Testing. The Wiley Handbook of Psychometric Testing 751 779 .
Daniella Laureiro-Martinez. 2017. Methodological Challenges and Advances in Managerial and Organizational Cognition. Methodological Challenges and Advances in Managerial and Organizational Cognition 279 314 .
Luke T Surry, Dario Torre & Steven J Durning. (2017) Exploring examinee behaviours as validity evidence for multiple-choice question examinations. Medical Education 51:10, pages 1075-1085.
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Holly O Witteman, Justin Presseau, Emily Nicholas Angl, Iffat Jokhio, JD Schwalm, Jeremy M Grimshaw, Beth Bosiak, Madhu K Natarajan & Noah M Ivers. (2017) Negotiating Tensions Between Theory and Design in the Development of Mailings for People Recovering From Acute Coronary Syndrome. JMIR Human Factors 4:1, pages e6.
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Susan Irvine, Brett Williams & Lisa McKenna. (2017) How are we assessing near-peer teaching in undergraduate health professional education? A systematic review. Nurse Education Today 50, pages 42-50.
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Marie-Lee Simard, Miriam Lacasse, Caroline Simard, Jean-Sébastien Renaud, Christian Rheault, Isabelle Tremblay & Luc Côté. (2018) Validation d'un outil critérié d'évaluation des compétences des résidents en médecine familiale : étude qualitative du processus de réponse. Pédagogie Médicale 18:1, pages 17-24.
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Jonathan Lazar, Jinjuan Heidi Feng & Harry Hochheiser. 2017. Research Methods in Human Computer Interaction. Research Methods in Human Computer Interaction 369 409 .
Hyung-Joo Chang, June Kang, Byung-Joo Ham & Young-Mee Lee. (2016) A functional neuroimaging study of the clinical reasoning of medical students. Advances in Health Sciences Education 21:5, pages 969-982.
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Wolff-Michael Roth, Kadriye Ercikan, Marielle Simon & Romeo Fola. (2015) The assessment of mathematical literacy of linguistic minority students: Results of a multi-method investigation. The Journal of Mathematical Behavior 40, pages 88-105.
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Ralph Pinnock, Louise Young, Fiona Spence, Marcus Henning & Wayne Hazell. (2015) Can Think Aloud Be Used to Teach and Assess Clinical Reasoning in Graduate Medical Education? . Journal of Graduate Medical Education 7:3, pages 334-337.
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Brian Sanjay Heist, Jed David Gonzalo, Steven Durning, Dario Torre & David Michael Elnicki. (2014) Exploring Clinical Reasoning Strategies and Test-Taking Behaviors During Clinical Vignette Style Multiple-Choice Examinations: A Mixed Methods Study. Journal of Graduate Medical Education 6:4, pages 709-714.
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Thierry Pelaccia, Jacques Tardif, Emmanuel Triby, Christine Ammirati, Catherine Bertrand, Valérie Dory & Bernard Charlin. (2014) How and When Do Expert Emergency Physicians Generate and Evaluate Diagnostic Hypotheses? A Qualitative Study Using Head-Mounted Video Cued-Recall Interviews. Annals of Emergency Medicine 64:6, pages 575-585.
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