Constructing case vignettes for evaluating clinical judgment: An empirical model

Studies of clinical judgment are frequently based on analogue research, which uses experimenter-controlled stimuli to elicit judgments. The stimuli may be live models, audio- or video-taped models, or written case vignettes describing a clinical encounter. A major challenge of analogue research is to construct stimuli that maintain a balance between experimental rigor and clinical reality. An ideal set of case vignettes, for example, will contain summaries that resemble actual case histories and that are varied only on the specific clinical factors being studied. The model presented here demonstrates the empirical development of written case analogues in which several variables are studied simultaneously. The model can be adapted to any setting in which professionals are required to make judgments or decisions about individuals. The vignettes described here have been used in a variety of clinical settings to assess the reliability of clinicians'judgments and to aid in evaluation and program planning.