Abstract
Background: The script concordance test (SCT) is a validated method of examining students’ clinical reasoning. Medical students’ professional skills are assessed during their postgraduate years as they study for a specialist qualification in general practice. However, no specific provision is made for assessing their clinical reasoning during their postgraduate study.Objective: The aim was to demonstrate the reliability and validity of the SCT in general practice and to determine if this tool could be used to assess medical students’ progress in acquiring clinical reasoning.Methods: A 135-question SCT was administered to postgraduate medical students at the beginning of their first year of specialized training in general practice, and then every six months throughout their three-year training, as well as to a reference panel of 20 expert general practitioners. For score calculation, we used the combined scoring method as the calculator made available by the University of Montreal’s School of Medicine in Canada. For the validity, student’ scores were compared with experts, p <.05 was considered statistically significant.Results: Ninety students completed all six assessments. The experts’ mean score (76.7/100) was significantly higher than the students’ score across all assessments (p <.001), with a Cronbach’s alpha value of over 0.65 for all assessments.Conclusion: The SCT was found to be reliable and capable of discriminating between students and experts, demonstrating that this test is a valid tool for assessing clinical reasoning skills in general practice.
Highlights
The objective of the initial training of medical students is for them to acquire medical skills
Professional skills and clinical reasoning are acquired during postgraduate medical training, including practical training [1,2], which relies on setting-specific practice and training
The students were asked to respond using tables commonly used for multiplechoice question (MCQ) responses, such that each potential response on the five-point Likert scale corresponded to a possible response to a MCQ item
Summary
The objective of the initial training of medical students is for them to acquire medical skills. In France, it has been used in some places in a formative way but it is not used in a sanctioning way because it is not reproducible on large samples and depends on the operators In this context, certain researchers have examined tests assessing the overall medicals skills of general practitioners (GPs) [11,12]. The script concordance test (SCT) was developed in Canada around 15 years ago and is used to assess students’ clinical reasoning [13] This tool reflects the extent to which the candidates’ judgements map to those of a reference panel for the specialty in question in cases where there is clinical uncertainty [14]. The aim of this study was to demonstrate the reliability and validity of the SCT in the general practice context, and to assess whether this tool could be used to assess medical students’ progress in acquiring clinical reasoning
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