FonoTCS: validation of a tool for assessing clinical reasoning in Speech-Language pathology

To validate the internal structure of the Speech-Language Pathology Script Concordance Test (FonoTCS), which will be developed in a virtual, open-access format, to be used in the assessment of clinical reasoning among young professionals and students of speech-language pathology with a generalist background, speakers of Brazilian Portuguese.

This is a study to validate the internal structure of the instrument. Twenty-five specialist speech-language pathologists, with more than 10 years of generalist clinical experience, and 35 students summoned for Enade participated. Both groups evaluated the 30 clinical cases with 120 items from FonoTCS. For the final selection of specialists who made up the sample, judges whose evaluations showed Z2 results >2 and Z<-2 distant from the modal response were removed. For the selection of items present in the final format of the test, those that remained had a Pearson correlation between the transformed scores of students for a given item and the sum of the transformed scores for all items, with a value greater than 0.05. The Cronbach's Alpha test was applied to measure the internal consistency of FonoTCS, and the score of each item was defined based on the aggregated score method.

The responses of 13 specialists were considered for the definition of the final test score. The final instrument had 88 items distributed across 28 clinical cases. The internal consistency was 0.903 with a 95% confidence interval expressed by 0.86|---|0.95. These values indicate a high internal consistency among the items of FonoTCS.

FonoTCS is valid and reliable for use in evaluating the clinical reasoning of young professionals and speech-language pathology students with generalist training, who are Brazilian Portuguese speakers.