Experience with the script concordance test to develop clinical reasoning skills in pharmacy students

The script concordance test (SCT) is used to assess clinical reasoning and was originally developed for medical learners. The Accreditation Council for Pharmacy Education (ACPE) endorses the need for pharmacy students to develop clinical reasoning skills, but there is little documentation of use of the SCT for pharmacy learners.

A script concordance test activity was designed for a diabetes and metabolic syndrome pharmacotherapy course. Twenty-five cases were created and evaluated by an expert panel of 20 practicing pharmacists. Ten cases were presented as a formative activity in class. The students, design team, teaching team, and expert panel evaluated the activity.

The SCT was received positively from the students, design team, teaching team, and expert panel. The design team noted that case writing was different for this approach and that the inclusion of various perspectives from panelists was beneficial. Although the activity was formative in nature, the teaching team scored the students and this provided insight into areas where the students may struggle.

This report provides information on the formative use of the SCT in the classroom, as well as categories of items suitable for pharmacy. The SCT provides an approach to illustrate clinical reasoning and clinical decision making among content experts and can be used to stimulate clinical discussions among student learners and content experts. The SCT could help incorporate clinical reasoning skills in a pharmacy curriculum to meet ACPE standards.