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

Purpose To assess whether case-based questions elicit different thinking pr ocesses from factual knowledge-based questions. Method 20 general practitioners (GPs) and 20 students solved case-based que stions and matched factual knowledge-based questions while thinking aloud. Verbatim protocols were analysed. Five indicators were defined: extent of p rotocols; 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 d eliberation which has a magnitude and a direction. Results Cases elicited longer protocols than factual knowledge questions. S tudents re-read more given information than GPs. GPs gave an immediate resp onse on twice as many occasions as students. GPs re-ordered the case inform ation, whereas students re-read the information in the order it was present ed. This ordering difference was not found in the factual knowledge questio ns. 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 repr esent problem-solving ability better than those elicited by factual knowled ge questions.