Swipe om te navigeren naar een ander artikel
The script concordance test (SCT) is designed to assess clinical reasoning by adapting the likelihood of a case diagnosis, based on provided new information. In the standard instructions students are asked to exclude alternative diagnoses they have in mind when answering the questions, but it might be more authentic to include these. Fifty-nine final-year medical students completed an SCT. Twenty-nine were asked to take their differential diagnosis into account (adapted instructions). Thirty students were asked not to consider other diagnoses (standard instructions). All participants were asked to indicate for each question whether they were confused answering it with the given instructions (‘confusion indication’). Mean score of the test with the adapted instructions was 81.5 (SD 3.8) and of the test with the standard instructions 82.9 (SD 5.0) (p = 0.220). Cronbach’s alpha was 0.39 for the adapted instructions and 0.66 for the standard instructions. The mean number of confusion indications was 4.2 (SD 4.4) per student for the adapted instructions and 16.7 (SD 28.5) for the standard instructions (p = 0.139). Our attempt to improve SCTs reliability by modifying the instructions did not lead to a higher alpha; therefore we do not recommend this change in the instructional format.
Eva KW. What every teacher needs to know about clinical reasoning. Med Educ. 2004;38:98–106. CrossRef
Goblet F, Jacques A, Gagnon R, Charlin B, Shabah A. Poorly performing physicians: does the script concordance test detect bad clinical reasoning? J Contin Educ Health Prof. 2010;30:161–6. CrossRef
Park AJ, Barber MD, Bent AE, et al. Assessment of intraoperative judgment during gynecologic surgery using the script concordance test. Am J Obst Gynecol. 2010;203:240e1–6. CrossRef
Ramaekers S, Kremer W, Pilot A, Van Breukelen P, Van Keulen H. Assessment of competence in clinical reasoning and decision making under uncertainty: the script concordance test method. Assess Eval High Educ. 2010;35:661–73. CrossRef
Duggan P. How to answer a SCT question (for students and experts). The University of Adelaide, Faculty of Health Sciences. http://www.fpcmed2.umontreal.ca/www.health.adelaide.edu.au. Accessed 22 Dec 2011.
Kreiter CD. Commentary: the response process validity of a script concordance test item. Adv Health Sci Educ. 2012;17:7–9. CrossRef
Lubarsky S, Gagnon R, Charlin B. Script concordance test items response process: the argument for probability versus typicality. Adv Health Sci Educ. 2012;17:11–3. CrossRef
Elstein AS, Shulman LS, Sprafka SA. Medical problem solving. An analysis of clinical reasoning. Cambridge: Harvard University Press; 1978.
- Effects of two different instructional formats on scores and reliability of a script concordance test
W. E. Sjoukje van den Broek
Marianne V. van Asperen
Gerlof D. Valk
Olle Th. J. ten Cate
- Bohn Stafleu van Loghum