title: Constructing a question bank based on script concordance approach as a novel assessment methodology in surgical education.
abstract: BACKGROUND
  Script Concordance Test (SCT) is a new assessment tool that reliably assesses clinical reasoning skills. Previous descriptions of developing SCT-question banks were merely subjective. This study addresses two gaps in the literature: 1) conducting the first phase of a multistep validation process of SCT in Plastic Surgery, and 2) providing an objective methodology to construct a question bank based on SCT.
  
  
  METHODS
  After developing a test blueprint, 52 test items were written. Five validation questions were developed and a validation survey was established online. Seven reviewers were asked to answer this survey. They were recruited from two countries, Saudi Arabia and Canada, to improve the test's external validity. Their ratings were transformed into percentages. Analysis was performed to compare reviewers' ratings by looking at correlations, ranges, means, medians, and overall scores.
  
  
  RESULTS
  Scores of reviewers' ratings were between 76% and 95% (mean 86% ± 5). We found poor correlations between reviewers (Pearson's: +0.38 to -0.22). Ratings of individual validation questions ranged between 0 and 4 (on a scale 1-5). Means and medians of these ranges were computed for each test item (mean: 0.8 to 2.4; median: 1 to 3). A subset of test items comprising 27 items was generated based on a set of inclusion and exclusion criteria.
  
  
  CONCLUSIONS
  This study proposes an objective methodology for validation of SCT-question bank. Analysis of validation survey is done from all angles, i.e., reviewers, validation questions, and test items. Finally, a subset of test items is generated based on a set of criteria.
authors.affiliation: Plastic Surgery Division, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia.
authors.forename: Salah A
authors.initials: SA
authors.lastname: Aldekhayel
authors.forename: Nahar A
authors.initials: NA
authors.lastname: Alselaim
authors.forename: Mohi Eldin
authors.initials: ME
authors.lastname: Magzoub
authors.forename: Mohammad M
authors.initials: MM
authors.lastname: Al-Qattan
authors.forename: Abdullah M
authors.initials: AM
authors.lastname: Al-Namlah
authors.forename: Hani
authors.initials: H
authors.lastname: Tamim
authors.forename: Abdullah
authors.initials: A
authors.lastname: Al-Khayal
authors.forename: Sultan I
authors.initials: SI
authors.lastname: Al-Habdan
authors.forename: Mohammed F
authors.initials: MF
authors.lastname: Zamakhshary
mesh_terms: D002170:Canada; D002983:Clinical Competence; D003431:Cross-Cultural Comparison; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D015588:Observer Variation; D011340:Problem Solving; D018794:Problem-Based Learning / Q000379:methods*; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012529:Saudi Arabia; D013223:Statistics as Topic; D013518:Surgery, Plastic / Q000193:education*; D011795:Surveys and Questionnaires