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The cognitive process of test takers when using the script concordance test rating scale
Nada Gawad1,2, Timothy J Wood2, Lindsay Cowley2
1Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Medical Education
|January 9, 2020
Summary
The script concordance test (SCT) rating scale has interpretation issues among users. Revising the scale can improve the validity of clinical decision making (CDM) skills assessment.
Area of Science:
- Medical Education
- Cognitive Psychology
Background:
- Clinical decision making (CDM) skills are crucial for medical trainees.
- The script concordance test (SCT) is a common tool for assessing CDM.
- Existing criticisms of the SCT rating scale are largely theoretical.
Purpose of the Study:
- To investigate the cognitive processes of test takers using the SCT rating scale.
- To gather validity evidence for the SCT in CDM assessment.
Main Methods:
- Administered SCT cases to residents and staff surgeons.
- Conducted semi-structured cognitive interviews with participants based on SCT results.
- Coded interview data to understand response mapping to the rating scale.
Main Results:
- Identified five key issues in response matching: meaning of '0', agreement with management, rationale for '±1' vs '±2', desire for additional procedures, and time influence.
- Revealed inconsistent and unintended use of the SCT rating scale.
Conclusions:
- Test takers interpret the SCT rating scale in various ways.
- Revising the SCT scale could enhance response process validity and improve CDM assessment.
- Addressing interpretation issues is essential for the SCT's utility in evaluating CDM skills.
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