title: Using the Script Concordance Test to Evaluate Clinical Reasoning Skills in Psychiatry.
abstract: OBJECTIVE
  Although clinical reasoning is a major component of psychiatric training, most evaluating tools do not assess this skill properly. Clinicians mobilize networks of organized knowledge (scripts) to assess ambiguous or uncertain situations. The Script Concordance Test (SCT) was developed to assess clinical reasoning in an uncertainty context. The objective of this study was to test the usefulness of the SCT to assess the reasoning capacities of interns (7th year medical students) during the psychiatry training.
  
  
  METHODS
  The authors designed a SCT for psychiatry teaching, adapted to interns. The test contained 20 vignettes of five questions each. A reference panel of senior psychiatrists underwent the test, and we used their scoring as a reference for the student group. The SCT assessed the competence of students at the beginning and the end of their training in psychiatry.
  
  
  RESULTS
  A panel of 10 psychiatrists and 47 interns participated to this study. As expected, the reference panel performed significantly (p<0.001) better (79.4±5.1) than the students on the SCT. Interns improved significantly (p<0.001) their scores between the beginning (58.5±6.2) and the end (65.0±5.3) of their psychiatry rotation. The students improved significantly (p<0.001) their scores between the beginning and the end of the training (6.4±4.8).
  
  
  CONCLUSIONS
  This is the first study using the SCT in psychiatry. This study shows the feasibility of this procedure and its utility in the field of psychiatry for evaluating medical students in their clinical reasoning competence. It can provide a valid alternative to classical evaluation methods.
authors.affiliation: Faculty of Medicine, Saint Joseph University, Beirut, Lebanon. francoiskazour@hotmail.com.
authors.forename: François
authors.initials: F
authors.lastname: Kazour
authors.affiliation: Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.
authors.forename: Sami
authors.initials: S
authors.lastname: Richa
authors.affiliation: Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.
authors.forename: Marouan
authors.initials: M
authors.lastname: Zoghbi
authors.affiliation: Université François-Rabelais de Tours, Inserm UMR U930, Tours, France.
authors.forename: Wissam
authors.initials: W
authors.lastname: El-Hage
authors.affiliation: Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.
authors.forename: Fady G
authors.initials: FG
authors.lastname: Haddad
mesh_terms: D002983:Clinical Competence; D004501:Education, Medical; D004521:Educational Measurement / Q000379:methods; D006801:Humans; D007396:Internship and Residency; D018794:Problem-Based Learning; D011570:Psychiatry / Q000193:education*; D013850:Thinking; D035501:Uncertainty
keywords: Evaluation; Intern; Psychiatry; Reasoning; Script concordance test