title: Online script concordance test for clinical reasoning assessment in otorhinolaryngology: the association between performance and clinical experience.
abstract: OBJECTIVE
  To report on the creation and administration of an online Script Concordance Test (SCT) for ear, nose, and throat (ENT), the ENT-SCT.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Two tertiary care university centers.
  
  
  METHODS
  In total, 132 individuals were asked to test an ENT-SCT of 20 cases and 94 questions based on the major educational objectives of the ENT residency program.
  
  
  METHODS
  Three levels of experience were tested: medical students, ENT residents, and board-certified otorhinolaryngologists as the expert panel. The test's construct validity-whether scores were related to clinical experience-was statistically analyzed. Reliability was estimated by the Cronbach α internal consistency coefficient. Participants' perception of the test was assessed with the use of a questionnaire.
  
  
  RESULTS
  The 65 respondents with usable data were medical students (n = 21), ENT residents (n = 22), and experts (n = 22). Total mean (SD) test scores differed significantly: 76.81 (3.31) for the expert panel, 69.05 (4.35) for residents, and 58.29 (5.86) for students. The Cronbach α coefficient was 0.95. More than two-thirds of the participants found the test to be realistic and relevant for assessing clinical reasoning. The test was also considered fun, interesting, and intuitive.
  
  
  CONCLUSIONS
  The Web-based ENT-SCT is feasible, reliable, and useful for assessing clinical reasoning. This online assessment tool may have applications for residency programs and continuing medical education.
authors.affiliation: University Paris 5 Paris, Descartes, Paris, France. romain.kania@lrb.aphp.fr
authors.forename: Romain E
authors.initials: RE
authors.lastname: Kania
authors.forename: Benjamin
authors.initials: B
authors.lastname: Verillaud
authors.forename: Hugo
authors.initials: H
authors.lastname: Tran
authors.forename: Robert
authors.initials: R
authors.lastname: Gagnon
authors.forename: Driss
authors.initials: D
authors.lastname: Kazitani
authors.forename: Patrice Tran Ba
authors.initials: PT
authors.lastname: Huy
authors.forename: Philippe
authors.initials: P
authors.lastname: Herman
authors.forename: Bernard
authors.initials: B
authors.lastname: Charlin
mesh_terms: D002983:Clinical Competence; D004502:Education, Medical, Continuing; D004521:Educational Measurement; D007396:Internship and Residency; D008128:Logic; D009862:Online Systems; D010036:Otolaryngology / Q000193:education*; D011446:Prospective Studies; D013337:Students, Medical; D011795:Surveys and Questionnaires