Abstract
Introduction We created a clinical map (CM) puzzle for medical students to use as a material of a case study of an emergency room (ER) patient with a severe hemorrhagic stroke, and used it to quantitatively evaluate the structure of their medical knowledge. Methods Sixty-three 5th-year medical students divided into 21 groups were asked to complete a CM puzzle by placing each of 19 elements in an exact position. We counted the number of incorrect, unused, and correct elements. Incorrect elements were classified into three categories：step errors, practice errors, and combined errors. Results Mean (standard deviation), maximum and minimum numbers of placements in the 21 groups were：1) incorrect (1) step errors：2.3 (2.0), 7, and 0, (2) practice errors：0.6 (1.1), 4, and 0, (3) combined errors：1.1 (1.2), 4, and 0, 2) Unused：0.6 (0.9), 3, and 0, 3) Correct：14.3 (2.6), 19, and 9. Discussion The results revealed several kinds of mistakes concerning the initial management of a patient with severe hemorrhagic stroke. We were able to use the results to quantitatively evaluate the students' structure of medical knowledge by counting the number of the different types of errors. Conclusions A CM puzzle may useful for quantitative evaluation of the structure of students' medical knowledge.
