Script Concordance Tests for Formative Clinical Reasoning and Problem-Solving Assessment in General Pediatrics

Area of Science:

• Medical Education
• Clinical Reasoning Assessment

Background:

• Script Concordance Tests (SCTs) are valuable tools for assessing clinical reasoning in medical education.
• Incorporating SCTs into pediatric clerkships can enhance student learning and faculty feedback.
• Pediatric cases were chosen due to limited student exposure to common pediatric presentations.

Purpose of the Study:

• To develop and evaluate Script Concordance Tests (SCTs) for use in a pediatric clerkship.
• To assess the utility of SCTs in providing formative feedback to medical students.
• To explore the relationship between SCT performance and other summative assessments.

Main Methods:

• Eight themed SCTs with 72 items were developed focusing on general pediatrics.
• Tests were administered to third-year medical students during their pediatric clerkship (Fall 2016 - Spring 2020).
• Item analyses and comparisons with summative assessments were conducted to evaluate SCTs.

Main Results:

• The mean aggregate percentage score across all SCTs was 84% (SD = 8%).
• Student performance on SCTs showed a positive correlation with USMLE Step 2 Clinical Knowledge scores.
• SCT performance was also related to clerkship grades and NBME Pediatrics Shelf Exam scores.

Conclusions:

• SCTs effectively facilitate timely feedback to medical students in a clinical learning environment.
• These tests aid in evaluating student clinical reasoning and problem-solving abilities.
• SCTs can be used for single-point assessment or longitudinal tracking of student progress and knowledge gaps.