Script concordance testing: From theory to practice: AMEE Guide No. 75

Abstract

The script concordance test (SCT) is used in health professions education to assess a specific facet of clinical reasoning competence: the ability to interpret medical information under conditions of uncertainty. Grounded in established theoretical models of knowledge organization and clinical reasoning, the SCT has three key design features: (1) respondents are faced with ill-defined clinical situations and must choose between several realistic options; (2) the response format reflects the way information is processed in challenging problem-solving situations; and (3) scoring takes into account the variability of responses of experts to clinical situations. SCT scores are meant to reflect how closely respondents' ability to interpret clinical data compares with that of experienced clinicians in a given knowledge domain. A substantial body of research supports the SCT's construct validity, reliability, and feasibility across a variety of health science disciplines, and across the spectrum of health professions education from pre-clinical training to continuing professional development. In practice, its performance as an assessment tool depends on careful item development and diligent panel selection. This guide, intended as a primer for the uninitiated in SCT, will cover the basic tenets, theoretical underpinnings, and construction principles governing script concordance testing.

Methods and Outcomes for the Remediation of Clinical Reasoning

“…Reassessment was performed postremediation by an independent faculty member or team, as part of a routine clinical assessment based on the level of the learner; assessors were unaware that the learner was being remediated. Reassessment methods included observed structured clinical examinations with standardized patient encounters and script concordance testing, 33 repeating part or all of a rotation, mini-clinical evaluation examinations, chart stimulated recall, and attending and direct team rotation evaluations. The results of the reassessments were shared with the rotation or program director, who determined whether remediation was a success or failure.…”

Examples of assessment methods that can be used during clinical phase in medical education

“…Bir sonraki hastanız odaya girdiğinde, önceki vakaya bağlı olarak aktif olan senaryolar çalışan belleğinizden silinecek ve yeni vakayla ilgili olan senaryolar derhal aklınıza gelecektir. (12,14).…”

Prueba de concordancia de script: primera experiencia en pediatría de alcance nacional

“…2,3 Evaluar este razonamiento clínico es difícil con los modelos aplicados h a b i t u a l m e n t e e n l a f o r m a c i ó n profesional. 4 L a p r u e b a d e c o n c o r d a n c i a de script (PCS) (en inglés, Script Concordance Test -SCT-), descrita por Charlin y colaboradores en 1998, 5 es un instrumento de evaluación destinado a medir el razonamiento médico. 3 Se basa en comparar, frente a un caso específico, el desempeño del razonamiento clínico de los evaluados con el desarrollado por expertos.…”