Script Concordance Testing

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Introduction

Universite de Montreal site

 

 

One of the most important aspects of clinical care is reasoning in situations of ambiguity, where there is often incomplete information and there is no one correct course of action. Multiple choice questions are appropriate where there is a 'right' answer, but less so when uncertainty exists (Epstein, 1999). Script concordance testing (SCT) is a reliable, valid tool that was designed for assessing learners in these circumstances, based on the 'script' theory of clinical decisions. This theory states that knowledge becomes progressively organized into knowledge networks, referred to as scripts. These grow with increased clinical experience, to the point that their activation requires little effort (Schmidt, Norman, and Boshuizen, 1990).

Script-concordance testing provide clinical data and ask whether it supports or refutes a given clinical diagnosis.

 

 

Constructing SCT

A systematic review has revealed criteria for creating good SCT (Dory, Gagnon, Vanpee, and Charlin, 2012).

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Resources and References

 

Carrière B, Gagnon R, Charlin B, Downing S, Bordage G. 2009. Assessing clinical reasoning in pediatric emergency medicine: validity evidence for a Script Concordance Test. Ann Emerg Med. 53(5):647-52.

 

Dory V, Gagnon R, Vanpee D, Charlin B. 2012. How to construct and implement script concordance tests: insights from a systematic review. Medical Education. 46(6):552-563.

 

Duggan P, Charlin B. 2012. Summative assessment of 5th year medical students' clinical reasoning by Script Concordance Test: requirements and challenges. BMC Med Educ. 12:29.

 

Fournier JP, Demeester A, Charlin B. 2008. Script concordance tests: guidelines for construction. BMC Med Inform Decis Mak. 8:18.

 

Humbert AJ, Besinger B, Miech EJ. 2011. Assessing clinical reasoning skills in scenarios of uncertainty: convergent validity for a Script Concordance Test in an emergency medicine clerkship and residency. Acad Emerg Med. 18(6):627-34.

 

Humbert AJ, Johnson MT, Miech E, Friedberg F, Grackin JA, Seidman PA. 2011. Assessment of clinical reasoning: A Script Concordance test designed for pre-clinical medical students. Med Teach. 33(6):472-7.

 

Schmidt HG, Norman GR, Boshuizen HP. 1990. A cognitive perspective on medical expertise: theory and implication. Acad Med. 65:611-21.

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