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Developing Script Concordance Test Items in Otolaryngology to Improve Clinical Reasoning Skills: Validation using
Sivaraman Ganesan1, Shital Bhandary2, Mahalakshmy Thulasingam3
1Department of ENT, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
This study developed and validated a script concordance test (SCT) for otolaryngology, finding a consensus index above 60 effective for optimizing items and improving clinical reasoning assessment.
Area of Science:
- Medical Education
- Otolaryngology
- Assessment Methods
Background:
- Script concordance testing (SCT) is a common method for evaluating clinical reasoning.
- Developing and validating specialized SCTs is crucial for targeted medical education.
Purpose of the Study:
- To develop a script concordance test (SCT) specifically for otolaryngology.
- To validate the developed SCT using panel response patterns and consensus index.
Main Methods:
- Constructed 98 SCT items, administered to 20 otolaryngology experts.
- Analyzed panel response patterns and consensus index to optimize items.
- Administered the refined SCT to undergraduate and postgraduate students.
Main Results:
- An 82-item SCT was administered, yielding Cronbach's alpha of 0.74.
- Excluding 22 items, the final 60-item SCT achieved a Cronbach's alpha of 0.82.
- A consensus index above 60 indicated good item-total correlation.
Conclusions:
- A consensus index >60 is recommended for optimizing SCT items in otolaryngology.
- Panel response patterns can aid in item categorization, but bimodal/uniform patterns require further investigation.
- The validated 60-item SCT is suitable for assessing otolaryngology residents' clinical reasoning.
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