Lambert Carole, Gagnon Robert, Nguyen David, Charlin Bernard
CPASS, Faculty of Medicine, University of Montreal, CP 6128, Succursale Centre-Ville, Montreal, Quebec, H3C 3J7, Canada.
Radiat Oncol. 2009 Feb 9;4:7. doi: 10.1186/1748-717X-4-7.
The Script Concordance test (SCT) is a reliable and valid tool to evaluate clinical reasoning in complex situations where experts' opinions may be divided. Scores reflect the degree of concordance between the performance of examinees and that of a reference panel of experienced physicians. The purpose of this study is to demonstrate SCT's usefulness in radiation oncology.
A 90 items radiation oncology SCT was administered to 155 participants. Three levels of experience were tested: medical students (n = 70), radiation oncology residents (n = 38) and radiation oncologists (n = 47). Statistical tests were performed to assess reliability and to document validity.
After item optimization, the test comprised 30 cases and 70 questions. Cronbach alpha was 0.90. Mean scores were 51.62 (+/- 8.19) for students, 71.20 (+/- 9.45) for residents and 76.67 (+/- 6.14) for radiation oncologists. The difference between the three groups was statistically significant when compared by the Kruskall-Wallis test (p < 0.001).
The SCT is reliable and useful to discriminate among participants according to their level of experience in radiation oncology. It appears as a useful tool to document the progression of reasoning during residency training.
脚本一致性测试（SCT）是一种可靠且有效的工具，用于评估在专家意见可能存在分歧的复杂情况下的临床推理能力。分数反映了考生表现与经验丰富的医生组成的参考小组表现之间的一致程度。本研究的目的是证明SCT在放射肿瘤学中的实用性。
对155名参与者进行了一项包含90个项目的放射肿瘤学SCT测试。测试了三个经验水平：医学生（n = 70）、放射肿瘤学住院医师（n = 38）和放射肿瘤学家（n = 47）。进行了统计测试以评估可靠性并证明有效性。
经过项目优化后，测试包括30个病例和70个问题。克朗巴哈系数为0.90。学生的平均分数为51.62（±8.19），住院医师为71.20（±9.45），放射肿瘤学家为76.67（±6.14）。通过克鲁斯卡尔-沃利斯检验比较时，三组之间的差异具有统计学意义（p < 0.001）。
SCT可靠且有助于根据参与者在放射肿瘤学方面的经验水平进行区分。它似乎是记录住院医师培训期间推理进展的有用工具。
