title: Assessment in the context of uncertainty using the script concordance test: more meaning for scores.
abstract: BACKGROUND
  The Script Concordance Test (SCT) uses authentic, ill-defined clinical cases to compare medical learners' judgment skills with those of experienced physicians. SCT scores are meant to measure the degree of concordance between the performance of examinees and that of the reference panel. Raw test scores have meaning only if statistics (mean and standard deviation) describing the panel's performance are concurrently provided.
  
  
  OBJECTIVE
  The purpose of this study is to suggest a method for reporting scores that standardizes panel mean and standard deviation, allowing examinees to immediately gauge their performance relative to panel members.
  
  
  METHODS
  Based on a statistical method of standardization, a new method for computing SCT scores is described. According to this method, test raw scores are converted into a scale in which the panel mean is set as the value of reference, and the standard deviation of the panel serves as a yardstick by which examinee performance is measured.
  
  
  RESULTS
  The effect of this transformation on four data sets obtained from SCTs in radio-oncology, surgery, neurology, and nursing is discussed.
  
  
  CONCLUSIONS
  This transformation method proposes a common metric basis for reporting SCT scores and provides examinees with clear, interpretable insights into their performance relative to that of physicians of the field. We recommend reporting SCT scores with the mean and standard deviation of panel scores set at standard scores of 80 and 5, respectively. Beyond SCT, our transformation method may be generalizable to the scoring of other test formats in which the performance of examinees and those of a panel of reference undertaking the same cognitive tasks are compared.
authors.affiliation: Center of Pedagogy Applied to Health Sciences, University of Montreal, Montreal, Quebec, Canada. bernard.charlin@umontreal.ca
authors.forename: Bernard
authors.initials: B
authors.lastname: Charlin
authors.forename: Robert
authors.initials: R
authors.lastname: Gagnon
authors.forename: Stuart
authors.initials: S
authors.lastname: Lubarsky
authors.forename: Carole
authors.initials: C
authors.lastname: Lambert
authors.forename: Sarkis
authors.initials: S
authors.lastname: Meterissian
authors.forename: Colin
authors.initials: C
authors.lastname: Chalk
authors.forename: Johanne
authors.initials: J
authors.lastname: Goudreau
authors.forename: Cees
authors.initials: C
authors.lastname: van der Vleuten
mesh_terms: D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods*; D004522:Educational Status; D013502:General Surgery / Q000193:education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007858:Learning; D009462:Neurology / Q000193:education; D009729:Nursing; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D035501:Uncertainty