Gagnon Robert, Charlin Bernard, Roy Louise, St-Martin Monique, Sauvé Evelyne, Boshuizen Henny P A, van der Vleuten Cees
Unit for Research and Development In Health Sciences Education, University of Montreal, Montreal, Canada.
Teach Learn Med. 2006 Winter;18(1):22-7. doi: 10.1207/s15328015tlm1801_6.
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.
根据脚本一致性测试（SCT）所基于的理论，脚本包含了与每种疾病相关特征的预期，以及关于典型、非典型或不相容值范围的预期。
为了证明SCT的结构效度，我们研究了理论预测，即一旦激活一个脚本，对于该脚本而言典型的新传入信息（例如，额外的临床特征）比非典型信息处理得更快。如果信息不相容，处理时间则介于两者之间。
我们向两组参与者（30名四年级医学生和30名全职老年病科医生）展示了64个临床病例（分为老年病学中5种常见临床症状类型），每个病例都伴有一个旨在实例化适当脚本的诊断假设。接下来，我们展示了一个新发现，根据该假设，这个发现可能是典型的、非典型的或不相容的。参与者必须尽可能快速准确地决定这个新发现是增加、降低还是不影响诊断假设的可能性。我们在计算机上进行测试。因变量是处理时间。我们使用重复测量的2×3方差分析来分析数据。
典型信息比非典型和不相容信息处理得更快（分别为M = 10.6秒、19.2秒和16.4秒；两者p均<0.001）。不相容信息比非典型信息处理得更快（16.4秒对19.2秒；p < 0.001）。老年病科医生组和学生组之间没有显著差异。
根据给定假设下临床数据的典型性和相容性，可以预测哪种信息将被更快地处理。结果支持SCT的结构效度。
