Script Concordance Test in Physiology: Preparation, Scoring, and Student Perceptions - A Mixed Method Study.

Area of Science:

• Medical Education
• Physiology Education
• Clinical Skills Assessment

Background:

• Current medical curricula incorporate early clinical exposure (ECE) and self-directed learning.
• Traditional assessment tools like MCQs and essays fail to evaluate higher-order thinking and clinical reasoning skills.
• There is a need for assessment methods aligned with modern pedagogical approaches.

Purpose of the Study:

• To evaluate the effectiveness of script concordance tests (SCTs) as a formative assessment tool.
• To compare SCTs with traditional MCQs for assessing cognitive domains in medical physiology.
• To gather student perceptions on the utility of SCTs.

Main Methods:

• Two SCTs were developed for topics on shock and lung disorders, administered during ECE.
• The study involved 107 and 98 medical students for respiratory and cardiovascular topics, respectively.
• Student perceptions regarding the SCTs were collected.

Main Results:

• SCTs demonstrated good internal consistency (Cronbach's alpha 0.83 and 0.82).
• High inter-item correlations (0.71 and 0.69) suggest redundancy.
• Students perceived SCTs as difficult to understand (75.8%) and answer (47.2%) but effective for clinical content (71.4%).

Conclusions:

• SCTs show potential for assessing clinical reasoning in medical education.
• Despite perceived benefits, student challenges in understanding and answering SCTs limit their current application.
• Further refinement of SCTs may be needed to improve student acceptance and utility in assessments.