title: Assessment of intraoperative judgment during gynecologic surgery using the Script Concordance Test.
abstract: OBJECTIVE
  We sought to develop a valid, reliable assessment of intraoperative judgment by residents during gynecologic surgery based on Script Concordance Theory.
  
  
  METHODS
  This was a multicenter prospective study involving 5 obstetrics and gynecology residency programs. Surgeons from each site generated case scenarios based on common gynecologic procedures. Construct validity was evaluated by correlating scores to training level, in-service examinations, and surgical skill and experience using a Global Rating Scale of Operative Performance and case volumes.
  
  
  RESULTS
  A final test that included 42 case scenarios was administered to 75 residents. Internal consistency (Cronbach alpha = 0.73) and test-retest reliability (Lin correlation coefficient = 0.76) were good. There were significant differences between test scores and training levels (P = .002) and test scores correlated with in-service examination scores (r = 0.38; P = .001). There was no association between test scores and total number of cases or technical skills.
  
  
  CONCLUSIONS
  The Script Concordance Test appears to be a reliable, valid assessment tool for intraoperative decision-making during gynecologic surgery.
authors.affiliation: Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Park
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Barber
authors.forename: Alfred E
authors.initials: AE
authors.lastname: Bent
authors.forename: Yashika T
authors.initials: YT
authors.lastname: Dooley
authors.forename: Christina
authors.initials: C
authors.lastname: Dancz
authors.forename: Gary
authors.initials: G
authors.lastname: Sutkin
authors.forename: J Eric
authors.initials: JE
authors.lastname: Jelovsek
mesh_terms: D002170:Canada; D002983:Clinical Competence; D003657:Decision Making; D004521:Educational Measurement; D013509:Gynecologic Surgical Procedures / Q000193:education*; D006176:Gynecology / Q000193:education; D006801:Humans; D007396:Internship and Residency; D007432:Intraoperative Period; D007600:Judgment; D009774:Obstetrics / Q000193:education; D011446:Prospective Studies; D015203:Reproducibility of Results; D014481:United States