title: Is a web-based concordance test feasible to assess therapeutic decision-making skills in a French context?
abstract: BACKGROUND
  At the end of undergraduate medical curriculum, a written simulation-based examination is used in France to assess therapeutic decision-making skills and to rank students for the purpose of matching their training specialties. However, this examination based on a single assessment method remains a subject of debate.
  
  
  OBJECTIVE
  To study the feasibility of a web-based Concordance test for therapeutic decision-making assessment.
  
  
  METHODS
  A 12 clinical-case Concordance test was developed based on objectives for the undergraduate training program. The test was administered on line to candidates with different levels of clinical experience. Fifteen therapeutic teachers constituted the reference panel. Data analysis included analysis of variance, post-hoc test, and Cronbach's alpha.
  
  
  RESULTS
  One hundred and seventy participants (113 students, 34 residents, 23 physicians) fully completed the free-access test on line with no technical problems. Differences between the mean scores for groups were significant (p < 0.001). Significant differences occurred between fourth year students and residents (p < 0.001), fourth year students and physicians (p = 0.001). No difference was found between residents and physicians. Reliability coefficient was 0.67.
  
  
  CONCLUSIONS
  A web-based Concordance test in the field of therapeutic decision-making was considered feasible in a French learning environment. Further research is warranted to determine its usefulness as a part of the National Examination.
authors.affiliation: Department of Urology, Rouen University, Rouen, France. louis.sibert@chu-rouen.fr
authors.forename: Louis
authors.initials: L
authors.lastname: Sibert
authors.forename: Roch
authors.initials: R
authors.lastname: Giorgi
authors.forename: Badisse
authors.initials: B
authors.lastname: Dahamna
authors.forename: Jean
authors.initials: J
authors.lastname: Doucet
authors.forename: Bernard
authors.initials: B
authors.lastname: Charlin
authors.forename: Stefan J
authors.initials: SJ
authors.lastname: Darmoni
mesh_terms: D002983:Clinical Competence; D003657:Decision Making; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement / Q000379:methods*; D019317:Evidence-Based Medicine; D005240:Feasibility Studies; D005602:France; D006801:Humans; D020407:Internet; D010820:Physicians; D018794:Problem-Based Learning; D013812:Therapeutics