Script concordance tests: guidelines for construction.
BACKGROUND
SCT is used to assess clinical reasoning in ambiguous or uncertain situations. It allows testing on real-life situations that are not adequately measured with current tests. It probes the multiple judgments that are made in the clinical reasoning process. Scoring reflects the degree of concordance of these judgments to those of a panel of reference experts.


METHODS
SCT is an item format that is gaining acceptance in education in the health professions. However, there are no detailed guidelines on item writing, test scoring or test optimization.


RESULTS
The item format is described and the steps for preparing and administering reliable and valid SCTs are presented.


CONCLUSIONS
SCTs probe examinees on a specific clinical reasoning task: data interpretation, a crucial step in the clinical reasoning process. It is inferred that a high degree of concordance corresponds to optimal use of information in the context of these specific tasks and therefore provides an indication of clinical reasoning quality.
Fournier
Jean Paul
JP
CPASS, direction de la recherche, Faculté de Médecine, Université de Montréal, CP 6128, Succursale centre-ville, Montréal, Québec, H3C 3J7, Canada. Fournier.jp@chu-nice.fr
Demeester
Anne
A
Charlin
Bernard
B
D002983:Clinical Competence; D003627:Data Interpretation, Statistical; D003657:Decision Making; D004521:Educational Measurement / Q000379:methods*; D006282:Health Personnel / Q000193:education; D006801:Humans; D007600:Judgment; D015203:Reproducibility of Results; D035501:Uncertainty