Abstract

Objectives: To determine the relationship between script concordance test scores obtained at the end of clerkship rotation in ob-gyn and global performance measures for the entire curriculum as expressed by a preclinical and clerkship score in the Dean’s Letter. The relationship also considered two other existing instruments.MethodsA cross-sectional study was carried out on a convenience sample of 129 clerkship students. Three instruments (Script Concordance Test, Key-Features Examinations and In-Training Report) were used to assess clinical reasoning. Data were collected from four Montreal University Hospitals at the end of four consecutive obstetrics and gynecology rotations. The data pertaining to the Dean’s Letter were collected at the end of the clerkship training period.ResultsCronbach’s alpha values were 0.67 for the script concordance test and 0.36 for Key Features Examinations. A significantly positive correlation was found between the preclinical (r = 0.260, p = 0.01) and clerkship (r = 0.232, p = 0.01) scores of the Dean's Letter and the script concordance test. Regression analysis showed that the best predictor for the clerkship score of the Dean’s Letter was the script concordance test (r = 0.226, p = 0.014).ConclusionsThe script concordance test was associated with the scores in the Dean’s Letter in comparison with two other scales, which suggests that the test can be a useful tool for clinical educators who are engaged in the assessment of clinical reasoning, particularly in clerkship students. However, further work is required to establish this association.

Highlights

  • Evaluation of clinical reasoning presents a particular challenge to educators

  • One hundred and fifty-four (154) clerkship students sat for the paper and pencil 82-item script concordance test (SCT)

  • It is important to point out that SCT scores applied to ob-gyn rotations only, while the scores of the Dean’s Letter’s applied to the entire medical curriculum

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Summary

Introduction

Evaluation of clinical reasoning presents a particular challenge to educators. Whereas factual knowledge is relatively straightforward to assess using traditional testing methods (such as multiple choice or short-answer examinations), standardized measures of clinical reasoning are lacking. Assessment of clinical reasoning in clerkships involves global ratings by staff who observe students in the clinical setting over the length of a clinical rotation.[1] Key features exams represent another commonly used instrument. The script concordance test (SCT) is an innovative tool that assesses clinical data interpretation (CDI), a crucial component of clinical reasoning.[3] SCT assesses how examinees actively process information to confirm or eliminate diagnostic and management options with a series of qualitative judgments.[4] Students, residents, and physicians thoroughly accept the SCT format and find it relevant and interesting to complete.

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