[Assessment of medical students using a script concordance test at the end of their internship in pediatric...

The Script Concordance Test (SCT) is a tool used to evaluate clinical reasoning in complex medical situations. Our aim was to create the first SCT in pediatric gastroenterology in order to objectively assess medical students. We elaborated a SCT including 31 items divided into ten clinical cases. Topics were chosen within the list comprising the national academic exam. In order to assess medical students, a reference panel was made up of ten residents to establish the scoring process. Answers were noted on a Likert scale, ranging from -2 to +2. Scores were calculated based on the modal response. Depending on the variation of the experts' answers to each item, we classified the questions as correct, incorrect, or uncertain. The SCT was also taken by five GI pediatricians. The results were given as mean/20 ± SEM. The Student t-test was used for the statistical analysis. The scores were 15.35 ± 0.38 and 12.44 ± 0.58 (P=0.0006), respectively, for the reference panel and the students. Scores were unchanged by removing incorrect and uncertain questions. However, the score of the GI pediatricians was 13.37 ± 0.69, significantly lower than the reference panel (P=0.01). The reliability of this SCT is subject to debate. This was the first time the students had taken a SCT, but they considered that this tool was appropriate and in concordance with the objectives. Although the SCT is a useful method, its elaboration can be difficult. It seems important to create a group of teachers to validate the process and eliminate the wide variability.