Assessment of clinical reasoning: A Script Concordance test designed for pre-clinical medical students

Aloysius Humbert, Mary T. Johnson, Edward Miech, Fred Friedberg, Janice A. Grackin, Peggy A. Seidman

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: The Script Concordance test (SCT) measures clinical reasoning in the context of uncertainty by comparing the responses of examinees and expert clinicians. It uses the level of agreement with a panel of experts to assign credit for the examinee's answers. Aim: This study describes the development and validation of a SCT for pre-clinical medical students. Methods: Faculty from two US medical schools developed SCT items in the domains of anatomy, biochemistry, physiology, and histology. Scoring procedures utilized data from a panel of 30 expert physicians. Validation focused on internal reliability and the ability of the SCT to distinguish between different cohorts. Results: The SCT was administered to an aggregate of 411second-year and 70 fourth-year students from both schools. Internal consistency for the 75 test items was satisfactory (Cronbach's alpha = 0.73). The SCT successfully differentiated second- from fourth-year students and both student groups from the expert panel in a one-way analysis of variance (F2,508=120.4; p<0.0001). Mean scores for students from the two schools were not significantly different (p=0.20). Conclusion: This SCT successfully differentiated pre-clinical medical students from fourth-year medical students and both cohorts of medical students from expert clinicians across different institutions and geographic areas. The SCT shows promise as an easy-to-administer measure of "problem-solving" performance in competency evaluation even in the beginning years of medical education.

Original languageEnglish (US)
Pages (from-to)472-477
Number of pages6
JournalMedical Teacher
Volume33
Issue number6
DOIs
StatePublished - Jun 2011

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Medical Students
medical student
Students
expert
Aptitude
Medical Education
Medical Schools
Biochemistry
Uncertainty
Anatomy
Histology
Analysis of Variance
student
Physicians
school
biochemistry
physiology
analysis of variance
credit
physician

ASJC Scopus subject areas

  • Medicine(all)
  • Education

Cite this

Assessment of clinical reasoning : A Script Concordance test designed for pre-clinical medical students. / Humbert, Aloysius; Johnson, Mary T.; Miech, Edward; Friedberg, Fred; Grackin, Janice A.; Seidman, Peggy A.

In: Medical Teacher, Vol. 33, No. 6, 06.2011, p. 472-477.

Research output: Contribution to journalArticle

Humbert, Aloysius ; Johnson, Mary T. ; Miech, Edward ; Friedberg, Fred ; Grackin, Janice A. ; Seidman, Peggy A. / Assessment of clinical reasoning : A Script Concordance test designed for pre-clinical medical students. In: Medical Teacher. 2011 ; Vol. 33, No. 6. pp. 472-477.
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