Script Concordance Test in Pharmacology: Maiden experience from a Medical School in India

Script concordance test (SCT) is an innovative tool to teach and assess the clinical reasoning skills of medical students. It is the key aspect of clinical competency that enables the medical graduates to progress from novice to practicing general practitioner. SCT was used the first time in pharmacology to inculcate clinic reasoning skills in medical students by focusing on the topic of pharmacotherapy.

A SCT with a total of 18 questions, with 15 questions having 3 items each, one having four items and two questions having two items each was administered to 170 second year undergraduate medical students in the subject of pharmacology to assess the clinical reasoning skills. It was an interventional study conducted using convenience sampling technique with a sample size of 170. Aggregate scoring method was used to do the scoring obtained from the answers given by 10 expert-panel members in the field of pharmacology, which were used as an answer key to do the final scoring of the students. Descriptive statistics were computed using Students t test. SCT conduct included a small-group feedback session to the students post-SCT. A feedback questionnaire was administered to the students one week after the feedback session. Reliability of the SCT and feedback questionnaire was checked by calculating Cronbach alpha through Siegle reliability calculator. Content validity of the test as well as feedback questionnaire was done by the panel of experts included in the study.

Though the mean score of the students (27.68±4.59) was significantly lower than the expert panel (40.91±3.52), students were highly satisfied as they expressed that SCT enhanced their perceived clinical reasoning skills (median value=5) and critical thinking (median value=4). The Cronbach alpha for the test was 0.76. The students were also highly satisfied with the feedback given by the teachers after the SCT (median value=4).

SCT enhances critical thinking and clinical reasoning skills of the students, as reported by them. With the conduct of feedback session post-SCT, it can be used as assessment for learning tool and can be well used in a para-clinical subject of pharmacology.