title: Assessing clinical judgment using the Script Concordance test: the importance of using specialty-specific experts to develop the scoring key.
abstract: BACKGROUND
  The Script Concordance test (SCT) assesses clinical judgment. The purpose of this study was to determine whether a specialty-specific scoring key improves the validity of the SCT.
  
  
  METHODS
  Thirty experts from 6 general surgery disciplines answered questions pertaining to their area of expertise. We created a scoring key of 5 amalgamated expert panel members. The answers of 227 general surgery residents were analyzed.
  
  
  RESULTS
  The optimized test had a reliability level (Cronbach α) of .81. Scores increased progressively throughout all levels of training, with R5s scoring higher than R4s (R1, 42.7 ± 7.1; R2, 47.6 ± 7.5; R3, 48.7 ± 6.7; R4, 49.8 ± 7.7; R5, 52.9 ± 9.3). The average score of juniors (R1s + R2s, 45.1 ± 7.6) was significantly lower (P < .001) than seniors (R3s + R4s + R5s, 50.4 ± 8.0).
  
  
  CONCLUSIONS
  We showed that specialty-specific experts must be used to develop the scoring key. This has important implications in the application of the SCT on a wider level.
authors.affiliation: Department of Surgery, McGill University, Montreal, Quebec, Canada.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Petrucci
authors.forename: Thamer
authors.initials: T
authors.lastname: Nouh
authors.forename: Marylise
authors.initials: M
authors.lastname: Boutros
authors.forename: Robert
authors.initials: R
authors.lastname: Gagnon
authors.forename: Sarkis H
authors.initials: SH
authors.lastname: Meterissian
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003657:Decision Making; D005260:Female; D013502:General Surgery / Q000193:education* / Q000706:statistics & numerical data; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D007600:Judgment; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D018794:Problem-Based Learning; D011792:Quebec; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*; D000078329:Workforce