Abstract
BackgroundThe evaluation process of French medical students will evolve in the next few years in order to improve assessment validity. Script concordance testing (SCT) offers the possibility to assess medical knowledge alongside clinical reasoning under conditions of uncertainty. In this study, we aimed at comparing the SCT scores of a large cohort of undergraduate medical students, according to the experience level of the reference panel.MethodsIn 2019, the authors developed a 30-item SCT and sent it to experts with varying levels of experience. Data analysis included score comparisons with paired Wilcoxon rank sum tests and concordance analysis with Bland & Altman plots.ResultsA panel of 75 experts was divided into three groups: 31 residents, 21 non-experienced physicians (NEP) and 23 experienced physicians (EP). Among each group, random samples of N = 20, 15 and 10 were selected. A total of 985 students from nine different medical schools participated in the SCT examination. No matter the size of the panel (N = 20, 15 or 10), students’ SCT scores were lower with the NEP group when compared to the resident panel (median score 67.1 vs 69.1, p < 0.0001 if N = 20; 67.2 vs 70.1, p < 0.0001 if N = 15 and 67.7 vs 68.4, p < 0.0001 if N = 10) and with EP compared to NEP (65.4 vs 67.1, p < 0.0001 if N = 20; 66.0 vs 67.2, p < 0.0001 if N = 15 and 62.5 vs 67.7, p < 0.0001 if N = 10). Bland & Altman plots showed good concordances between students’ SCT scores, whatever the experience level of the expert panel.ConclusionsEven though student SCT scores differed statistically according to the expert panels, these differences were rather weak. These results open the possibility of including less-experienced experts in panels for the evaluation of medical students.
Highlights
The evaluation process of French medical students will evolve in the few years in order to improve assessment validity
Construction of the test This work was conducted by a group of 20 physicians and medical students involved in medical education and evaluation at the medical schools of Paris Diderot and Paris Descartes Universities, France
The expert panel consisted of 75 experts, including 43 cardiologists and 32 emergency physicians
Summary
The evaluation process of French medical students will evolve in the few years in order to improve assessment validity. Script concordance testing (SCT) offers the possibility to assess medical knowledge alongside clinical reasoning under conditions of uncertainty. The evaluation process of medical students before they become certified doctors is a major educational challenge This assessment should evaluate medical knowledge and competencies such as clinical reasoning. Script concordance testing (SCT) is a validated method that offers the possibility to assess medical knowledge alongside clinical reasoning under conditions of uncertainty [3, 4]. This assessment tool was designed with the cognitive psychology script theory in order to objectively examine if the students’ knowledge is organized for clinical decision-making [3]. SCT is designed to assess a candidate’s reasoning skills with the challenging decisions that are encountered during real-life clinical practice for diagnosis, investigation or treatment of patients [3, 4]
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