title: Use of the script concordance approach to evaluate clinical reasoning in food-ruminant practitioners.
abstract: A script concordance test (SCT) was developed measuring clinical reasoning of food-ruminant practitioners for whom potential clinical competence difficulties were identified by their provincial professional organization. The SCT was designed to be used as part of a broader evaluation procedure. A scoring key was developed based on answers from a reference panel of 12 experts and using the modified aggregate method commonly used for SCTs. A convenient sample of 29 food-ruminant practitioners was constituted to assess the reliability and precision of the SCT and to determine a fair threshold value for success. Cronbach's α coefficients were computed to evaluate internal reliability. To evaluate SCT precision, a test-retest methodology was used and measures of agreement beyond chance were computed at question and test levels. After optimization, the 36-question SCT yielded acceptable internal reliability (Cronbach's α=0.70). Precision of the SCT at question level was excellent with 33 questions (92%) yielding moderate to almost perfect agreement between administrations. At test level, fair agreement (concordance correlation coefficient=0.32) was observed between administrations. A slight SCT score improvement (M=+2.8 points) on the second administration was in part responsible for some of the disagreement and was potentially a result of an adaptation to the SCT format. Scores distribution was used to determine a fair threshold value for success, while considering the underlying objectives of the examination. The data suggest that the developed SCT can be used as a reliable and precise measurement of clinical reasoning of food-ruminant practitioners.
authors.affiliation: Department of Pathology and Microbiology, University of Montreal, St-Hyacinthe, Canada. simon.dufour@umontreal.ca
authors.forename: Simon
authors.initials: S
authors.lastname: Dufour
authors.forename: Sylvie
authors.initials: S
authors.lastname: Latour
authors.forename: Yvan
authors.initials: Y
authors.lastname: Chicoine
authors.forename: Gilles
authors.initials: G
authors.lastname: Fecteau
authors.forename: Sylvain
authors.initials: S
authors.lastname: Forget
authors.forename: Jean
authors.initials: J
authors.lastname: Moreau
authors.forename: André
authors.initials: A
authors.lastname: Trépanier
mesh_terms: D000818:Animals; D002983:Clinical Competence; D003657:Decision Making; D004520:Education, Veterinary / Q000379:methods*; D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D011340:Problem Solving; D011364:Professional Practice; D011792:Quebec; D015203:Reproducibility of Results; D012418:Ruminants; D018634:Veterinarians / Q000523:psychology*