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Examining response process validity of script concordance testing: a think-aloud approach.

Michael Siu Hong Wan1, Elina Tor1, Judith N Hudson2

  • 1School of Medicine, The University of Notre Dame Australia, Australia.

International Journal of Medical Education
|June 26, 2020
PubMed
Summary

Script Concordance Testing (SCT) scores in medical education are valid for assessing clinical reasoning. A think-aloud method confirmed that student justifications align with expert reasoning, supporting SCT

Keywords:
assessmentclinical reasoningresponse process validityscript concordance testingwritten think-aloud

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Area of Science:

  • Medical Education
  • Clinical Reasoning Assessment

Background:

  • Script Concordance Testing (SCT) is a tool used in medical education.
  • Validating the clinical reasoning process behind student responses is crucial for accurate assessment.

Purpose of the Study:

  • To investigate the response process validity of Script Concordance Testing (SCT) scores in undergraduate medical students.
  • To determine if student justifications for SCT responses align with expert clinical reasoning.

Main Methods:

  • Administered SCT items online to third and fourth-year medical students.
  • Utilized a think-aloud approach where students provided written reasoning for their responses.
  • Analyzed and compared student-provided reasoning with an expert reference panel's justifications.

Main Results:

  • High concordance rates were observed between student reasoning and expert reasoning for both full (99.6%) and partial credit (99.4%) responses.
  • The true negative rate was 99.0%, indicating that most no-credit responses stemmed from faulty clinical reasoning.
  • 209 students completed the online tests with a response rate of 68.3%.

Conclusions:

  • SCT scores demonstrate response process validity in undergraduate medical education.
  • The think-aloud component provides valuable insights into student learning and clinical reasoning.
  • SCT scores require validation for each testing occasion and across different educational contexts.