The script concordance test as a measure of clinical reasoning: a national validation study

Nouh, Thamer; Boutros, Marylise; Gagnon, Robert; Reid, Susan; Leslie, Kenneth A.; Pace, David; Pitt, Dennis; Walker, Robert V.; Schiller, Dan; MacLean, Anthony R.; Hameed, Morad; Fata, Paola; Charlin, Bernard; Meterissian, Sarkis

doi:10.1016/j.amjsurg.2011.11.006

Cited by 58 publications

(53 citation statements)

References 17 publications

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“…This number corresponds to what has been found in other studies. 1,6,[8][9][10][11][12][13][14] In the present study, the SCT was applied to students at different stages of the medicine program at FM-UFG, from the pre-clinical phase (first and second years) to the clinical phase (third, fourth and fifth years). Students in the pre-clinical phase obtained a mean of 51.6% of the maximum score, and those in the clinical phase obtained a mean of 63.4% of the maximum score.…”

Section: Discussionmentioning

confidence: 99%

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Script concordance test in medical schools in Brazil: possibilities and limitations

Roberti

Pereira

et al. 2016

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: Routine use of the script concordance test (SCT) is not common in Brazilian universities. This study aimed to analyze application of the SCT in the medical school of a Brazilian university. DESIGN AND SETTING: Quantitative, analytical and descriptive study in the medical school of a Brazilian university. METHODS: A total of 159/550 students participated. The test comprised ten clinical cases within internal medicine, with five items per case, rated on a five-point Likert scale. The test was scored in accordance with a marking key that had been validated by a reference panel. RESULTS:In the pre-clinical and clinical phases, the mean scores were 51.6% and 63.4% of the maximum possible scores, respectively. Comparison of the means of the responses among all the years showed that there were significant differences in 40% of the items. The panel marked all the possible answers in five items, while in one item, all the panelists marked a single answer. Cronbach's alpha was 0.64. The results indicated that the more senior students performed better. Construction of an SCT with discriminative questions was not easy. The low reliability index may have occurred due to: a) problems with the construction of the questions; b) limitations of the reference panel; and/or c) the scoring key. CONCLUSION:This instrument is very difficult to construct, apply and correct. These difficulties may make application of an SCT as an assessment method unfeasible in units with limited resources. RESUMO

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Section: Discussionmentioning

confidence: 99%

“…4 The instrument has been developed in various educational settings and in different countries and languages and is based on written presentation of short clinical cases, followed by a choice of diagnostic and therapeutic decisions. 1,[5][6][7][8][9][10][11][12][13] Routine use of the SCT is not common in Brazilian universities.…”

Section: Introductionmentioning

confidence: 99%

Script concordance test in medical schools in Brazil: possibilities and limitations

Roberti

Pereira

et al. 2016

Sao Paulo Med. J.

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“…13,14,19,28 Studies have shown that SCT scores correlate well with other assessment scores from the clinical years of the candidates. 2 The construct validity of SCT questions can be examined by correlating the scores with the level of training to predict future performance on clinical reasoning.…”

Section: Reliability and Validity Of Script Concordance Test As An Asmentioning

confidence: 99%

“…2,6 A 60-to 90-minute examination will produce a Cronbach's alpha of 0.70 to 0.85. 7,25,27,28 There are concerns, however, about inter-panellist errors in SCT; the use of Cronbach's alpha in measuring the reliability of the test where partial credit model of scoring is used, ie multiple options/ responses are awarded either a full or fraction of allocated mark; and case scenarios that could create inconsistencies among items.…”

Section: Reliability and Validity Of Script Concordance Test As An Asmentioning

confidence: 99%

“…In fact, SCT is one of the few currently available assessment tools for clinical reasoning in a written format. 28 It can be implemented relatively easily in the paper-based format or online. Initial pilot examinations can be set as a formative exercise to enhance candidates' feedback and learning.…”

Section: The Use Of Script Concordance Test In the Asia-pacific Regiomentioning

confidence: 99%

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Using the script concordance test to assess clinical reasoning skills in undergraduate and postgraduate medicine

Wan

2015

Hong Kong Med J

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A B S T R A C TThe script concordance test is a relatively new format of written assessment that is used to assess higherorder clinical reasoning and data interpretation skills in medicine. Candidates are presented with a clinical scenario, followed by the reveal of a new piece of information. The candidates are then asked to assess whether this additional information increases or decreases the probability or likelihood of a particular diagnostic, investigative, or management decision. To score these questions, the candidate's decision in each question is compared with that of a reference panel of expert clinicians. This review focuses on the development of quality script concordance Using the script concordance test to assess clinical reasoning skills in undergraduate and postgraduate medicine

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Measuring Decision‐Making During Thyroidectomy: Validity Evidence for a Web‐Based Assessment Tool

et al. 2017

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The script concordance test as a measure of clinical reasoning: a national validation study

Cited by 58 publications

References 17 publications

Script concordance test in medical schools in Brazil: possibilities and limitations

Script concordance test in medical schools in Brazil: possibilities and limitations

Using the script concordance test to assess clinical reasoning skills in undergraduate and postgraduate medicine

Measuring Decision‐Making During Thyroidectomy: Validity Evidence for a Web‐Based Assessment Tool

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