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Improving the validity of script concordance testing by optimising and balancing items.

Michael Sh Wan1, Elina Tor1, Judith Nicky Hudson2

  • 1School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia.

Medical Education
|January 11, 2018
PubMed
Summary
This summary is machine-generated.

To improve the validity of script concordance tests (SCTs), a balanced approach in item construction is recommended. This strategy mitigates score inflation caused by students avoiding extreme answer options, particularly benefiting lower-performing students.

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Area of Science:

  • Medical Education
  • Assessment and Evaluation

Background:

  • Script Concordance Tests (SCTs) assess clinical reasoning.
  • Concerns exist regarding SCT validity due to potential score inflation from students avoiding extreme answer options.

Purpose of the Study:

  • To investigate if avoiding extreme options inflates SCT scores.
  • To determine if a balanced item construction approach improves SCT validity.

Main Methods:

  • Paired t-tests compared actual student scores with simulated scores (re-coding extreme responses and scoring all as neutral).
  • Actual scores from 2012 (pre-balanced approach) were compared with 2013-2016 (post-balanced approach).

Main Results:

  • In 2012, simulation 1 showed a score increase in the third-year cohort (50.2% to 55.6%).
  • Since 2013, the balanced approach yielded significantly higher actual SCT scores (57.4%) compared to simulation 1 (46.7%) and simulation 2 (23.9%).

Conclusions:

  • Balancing SCT items to include both extreme and median response options is crucial.
  • This balanced approach can mitigate validity threats, especially for students who tend to avoid extreme responses.