Assessment of clinical reasoning competence in urology with the script concordance test: an exploratory study across two sites from different countries.
OBJECTIVE
The script concordance (SC) test is designed to measure the organisation of knowledge that allows interpretation of data in clinical reasoning. This study explores the use of this new written examination tool in urology.


METHODS
An 80 items SC test was administered to participants from a French and a Canadian university. Three levels of experience were tested: urologists (n = 22), residents in urology (n = 25) and students (n = 23). Scores between groups were compared by analysis of variance. Reliability analysis was studied with Cronbach alpha coefficient.


RESULTS
Mean global scores were 51.45 +/- 5.29 for students, 58.19 +/- 3.81 for residents and 62.27 +/- 5.46 for urologists. The difference between the three groups was statistically significant (P < 0.00001). Interaction between levels of expertise and sites was apparently not significant (P = 0.326). Cronbach alpha was 0.79 for the test.


CONCLUSIONS
This study shows that the SC test is able to discriminate among participants according to their levels of clinical experience in urology. The results are similar in two different learning environments. The SC test appears as a simple and direct approach to testing organisation and use of knowledge in urology.
Department of Urology, Rouen University Hospital-Charles-Nicolle, Pavillon Derocque 1, rue de Germont, 76031 Rouen, France. louis.sibert@chu-rouen.fr
Louis
L
Sibert
Bernard
B
Charlin
Jacques
J
Corcos
Robert
R
Gagnon
Joel
J
Lechevallier
Philippe
P
Grise
D002983:Clinical Competence; D004521:Educational Measurement / Q000379:methods*; D005602:France; D006801:Humans; D011792:Quebec; D014572:Urology / Q000193:education*