Is the SCRIPT an useful tool to assess clinical reasoning ability in medical students?

Abstract

Background: Numerous investigations indicate that the way of evaluating knowledge exerts a substantial influence on the change in the learning styles of students. Both the training of future professionals and their evaluation must be considered as one of the fundamental pillars on which the teaching-learning process must be based. The valid and reliable evaluation of clinical reasoning during the medical training process is essential. Determining which assessment method is the most useful for assessing clinical reasoning ability in medical students is not an easy task. Methods: An explanatory, observational, cross-sectional study with a prospective approach will be carried out. A SCRIPT test will be carried out on the students of the last year of the Medicine career, in order to measure the reliability, validity, educational impact and acceptability of said method. Results: Evaluations were carried out on a total of 81 students.59.3% were women and 40.7% were men. The general average of all those surveyed, taking into account deferrals, is 7.41. After having uploaded the data obtained and giving the corresponding score to each answer, according to the value designated by the experts, we have obtained a Cronbach's Alpha of 0.33. Conclusion: The results obtained in this study, although the authors propose a minimum of 20 clinical vignettes, were not the expected. Both the utility and the reliability of the SCRIPT tests are not sufficient by themselves to allow a correct evaluation of clinical analysis in medical students. We believe it is necessary that clinical reasoning be evaluated in an integrated, longitudinal, and coherent manner, using multiple evaluation methods and periodic and constructive feedback.