Evaluating clinical reasoning in first year DPT students using a script concordance test

Area of Science:

• Medical Education
• Physical Therapy
• Clinical Reasoning Assessment

Background:

• Script Concordance Tests (SCTs) are used to evaluate clinical reasoning in healthcare education.
• Their application in entry-level Doctor of Physical Therapy (DPT) programs remains unexplored.
• This study aimed to develop and validate an SCT for first-year DPT students.

Purpose of the Study:

• To develop a Script Concordance Test (SCT) for assessing clinical reasoning in first-year Doctor of Physical Therapy (DPT) students.
• To evaluate the reliability and validity of the developed SCT.

Main Methods:

• A four-phase development process included faculty consultation, vignette creation (30 vignettes, 3 questions each), pilot testing with clinicians, and administration to students and a reference panel.
• Internal consistency was assessed using Cronbach's Alpha, score differences analyzed with a t-test, and correlations with academic records explored using Spearman's Rho.

Main Results:

• The SCT demonstrated good internal consistency (Cronbach's Alpha = 0.74).
• A statistically significant difference was observed between first-year DPT students (mean 58.5%) and the experienced physical therapist reference panel (mean 65.8%, p < 0.01).
• No significant correlations were found between student SCT scores and their academic records.

Conclusions:

• The developed SCT is a reliable tool with satisfactory internal consistency for assessing clinical reasoning in DPT students.
• The SCT effectively distinguished between the performance of students and experienced clinicians.
• SCTs hold promise for measuring clinical reasoning in DPT education and informing pedagogical strategies.