Do short cases elicit different thinking processes than factual knowledge questions do?

Purpose To assess whether case‐based questions elicit different thinking processes from factual knowledge‐based questions. Method 20 general practitioners (GPs) and 20 students solved case‐based questions and matched factual knowledge‐based questions while thinking aloud. Verbatim protocols were analysed. Five indicators were defined: extent of protocols; immediate responses; re‐reading of information given in the stem or case after the question had been read; order of re‐reading information, and type of consideration, i.e. ‘true–false’ type or ‘vector’, that is, a deliberation which has a magnitude and a direction. Results Cases elicited longer protocols than factual knowledge questions. Students re‐read more given information than GPs. GPs gave an immediate response on twice as many occasions as students. GPs re‐ordered the case information, whereas students re‐read the information in the order it was presented. This ordering difference was not found in the factual knowledge questions. Factual knowledge questions mainly led to ‘true–false’ considerations, whereas cases elicited mainly ‘vector’ considerations. Conclusion Short case‐based questions lead to thinking processes which represent problem‐solving ability better than those elicited by factual knowledge questions.