[Show abstract][Hide abstract] ABSTRACT: According to the theory on which the Script Concordance Test (SCT) is based, scripts contain expectations on features that are associated with each illness and about the range of values that are typical, atypical, or incompatible.
To document the construct validity of the SCT, we investigated the theory prediction that once a script is activated, new incoming information (e.g., additional clinical features) is processed faster if it is typical for that script than if it is atypical. If it is incompatible, processing time falls in between.
We presented 2 groups of participants (30 fourth-year medical students and 30 full-time geriatricians) with 64 clinical vignettes (divided over 5 types of prevalent clinical presentations in geriatrics), each accompanied by a diagnostic hypothesis aimed to instantiate an appropriate script. Next, we presented a new finding, which could be typical, atypical, or incompatible given the hypothesis. Participants had to decide as quickly and accurately as possible whether the new finding increased, decreased, of did not affect the likelihood of the diagnostic hypothesis. We administered the test on a computer. The dependent variable was processing time. We analyzed data with a repeated measure 2 x 3 analysis of variance.
Typical information was processed faster than atypical and incompatible information (M = 10.6 sec vs. 19.2 sec and 16.4 sec, respectively; p lt; .001 for both). Incompatible information was processed faster than atypical information (16.4 sec vs. 19.2; p < .001). There was no significant difference between the groups of geriatricians and students.
It is possible to predict what kind of information will be processed faster depending of the typicality and compatibility of clinical data for given hypotheses. Results support SCT construct validity.
Full-text · Article · Dec 2006 · Teaching and Learning in Medicine
[Show abstract][Hide abstract] ABSTRACT: The Script Concordance (SC) test is a new assessment tool. It is designed to probe whether knowledge of examinees is efficiently organized for clinical actions. That kind of organization of knowledge is named a script. The SC test places examinees in written, but authentic, clinical situations in which they must interpret data to make decisions.
The SC test is designed to measure the degree of concordance that exists between examinees' scripts and scripts of a panel of experts. The objective of this article is to provide interested educators with the practical "how to" information needed to build and use an SC test.
The theoretical background of the SC test is described. The principles of construction of an SC test are presented, including the writing of clinical cases, the choice of item format, the validation of the test, and the elaboration of the scoring system.
A series of studies have shown that the SC test has interesting psychometric properties, in terms of reliability, face validity, and construct validity. Results from these studies are succinctly presented and commented.
The SC test is a simple and direct approach to testing organization and use of knowledge. It has the strong advantage for a testing method of being relatively easy to construct and use and to be machine-scorable. It can be either paper- or computer-based and can be used in undergraduate, postgraduate, or continuing medical education.
Full-text · Article · Feb 2000 · Teaching and Learning in Medicine