Abstract
This article was migrated. The article was marked as recommended. Background: The Script Concordance Test (SCT) is being increasingly used in professional development in clinical reasoning (CR) in postgraduate medicine. On-line delivery favours multi-institutional collaboration. Objectives: To establish if: 1) SCT questions developed in the French-speaking University of Montreal were readily adaptable for use in the English-speaking University of Adelaide 2) expert reference panels (ERP) from both institutions could be used interchangeably 3) student cohorts would perform similarly in the same test. Study Design: 82 SCT questions based on 27 clinical cases in Obstetrics and Gynaecology were developed in Montreal and run in a volunteer cohort of year 3 and year 4 medical students (n=154). Local faculty translated all questions, selecting 31 based on 17 clinical cases for use in summative examinations a year 5 student cohort in Adelaide (n=123). Results: Mean (SD) percentage scores using each ERP key were: 74.2 (6.4) versus 73.3 (6.9), p<0.001 for Adelaide students and 72.5 (7.8) versus 70.6 (8.8), p<0.001 for Montreal students. The correlation coefficients were ≥ 0.928 (p<0.001). Conclusions: Student cohorts performed similarly regardless of which ERP key was used. With appropriate editorial control, SCT's can be effectively shared between French and English-speaking institutions located in different hemispheres. Potential advantages include the creation of an international database of assessment items, benchmarking and cost sharing.
Highlights
Clinical reasoning (CR) is a cornerstone of medical practice
Study Design: 82 Script Concordance Test (SCT) questions based on 27 clinical cases in Obstetrics and Gynaecology were developed in Montreal and run in a volunteer cohort of year 3 and year 4 medical students (n=154)
Tests of clinical reasoning (CR) are becoming increasingly important in the postgraduate domain, where it is recognized that errors in CR make the single most significant contribution to successful malpractice claims. (Saber Tehrani 2013) The Script Concordance Test (SCT) is a tool for assessment of CR that is increasingly being used in continuing professional development in medicine (Ahmadi et al 2014) including in large, geographically dispersed medical communities. (Hornos et al 2013)
Summary
Clinical reasoning (CR) is a cornerstone of medical practice. Whilst most methods of teaching and assessing CR have their own benefits and drawbacks a common element is that testing CR is resource-intensive. (Saber Tehrani 2013) The Script Concordance Test (SCT) is a tool for assessment of CR that is increasingly being used in continuing professional development in medicine (Ahmadi et al 2014) including in large, geographically dispersed medical communities. (Brailovsky et al 2001, Brazeau-Lamontagne et al 2004, Lambert et al 2009, Lubarsky et al 2009, Meterissian et al 2006, Park et al 2010) In these reports, tests were statistically reliable and showed construct validity (Lubarsky et al 2011), with statistically linear progression of scores with clinical experience. These studies in postgraduate medicine have been undertaken with participants of differing levels of clinical expertise.
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