Delavari Somayeh, Amini Mitra, Sohrabi Zohreh, Koohestani Hamidreza, Delavari Sajad, Rezaee Rita, Mohammadi Elaheh, Demeester Anne, Charlin Bernard, Kheirkha Masoomeh
Department of Medical Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Center for Educational Research in Medical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2018 Aug 23;32:75. doi: 10.14196/mjiri.32.75. eCollection 2018.
Clinical reasoning plays an important role in the accurate diagnosis and treatment of diseases. Script Concordance test (SCT) is one of the tools that assess clinical reasoning skill. This study was conducted to determine the reliability and concurrent and predictive validity of SCT in assessing final lessons and gynecology exams of undergraduate midwifery students. At first, 20 clinical scenarios followed by 3 questions were designed by 2 experienced midwives. Then, after examining the content validity, 15 scenarios were selected. The test was used for 55 midwifery students. The correlation of SCT results with grade point average (GPA) was measured. To evaluate the concurrent validity of SCT, the correlation between SCT scores and the final exam of the gynecology course was measured. To measure predictive validity, the correlation of SCT scores with comprehensive exams of midwifery was calculated. Data were analyzed using SPSS software. Descriptive statistics, Pearson correlation, and coefficient Cronbach's alpha were used for analysis. The test's item difficulty level (IDL) and item discriminative index (IDI) were determined using Whitney and Sabers' method. The internal reliability of the test (calculated using Cronbach's alpha coefficient) was 0.74. All questions were positively correlated with the total score. The highest correlation coefficient was related to GPA and comprehensive test with the score of 0.91. The correlation coefficient between SCT and the final test (concurrent validity) was 0.654, and the correlation coefficient between SCT and comprehensive test (predictive validity) was 0.721. The range of item discriminative index and item difficulty level in this exam was 0.39-0.59 and 0.32-0.66, respectively. SCT shows a relatively high internal validity and can predict the success rate of students in the comprehensive exams of midwifery. Also, it showed a high concurrent validity in the final test of gynecology course. This test could be a good alternative for formative and summative tests of clinical courses.
临床推理在疾病的准确诊断和治疗中起着重要作用。脚本一致性测试（SCT）是评估临床推理技能的工具之一。本研究旨在确定SCT在评估本科助产专业学生的妇科期末考试中的可靠性、同时效度和预测效度。首先，由2名经验丰富的助产士设计了20个临床情景，每个情景后接3个问题。然后，在检验内容效度后，选择了15个情景。该测试用于55名助产专业学生。测量了SCT结果与平均绩点（GPA）的相关性。为了评估SCT的同时效度，测量了SCT分数与妇科课程期末考试之间的相关性。为了测量预测效度，计算了SCT分数与助产综合考试的相关性。使用SPSS软件分析数据。描述性统计、Pearson相关性和Cronbach's alpha系数用于分析。使用Whitney和Sabers的方法确定测试的项目难度水平（IDL）和项目区分指数（IDI）。测试的内部可靠性（使用Cronbach's alpha系数计算）为0.74。所有问题与总分均呈正相关。最高相关系数与GPA和综合测试相关，得分为0.91。SCT与期末考试（同时效度）之间的相关系数为0.654，SCT与综合测试（预测效度）之间的相关系数为0.721。本次考试中项目区分指数和项目难度水平的范围分别为0.39 - 0.59和0.32 - 0.66。SCT显示出相对较高的内部效度，并且可以预测助产综合考试中学生的成功率。此外，它在妇科课程期末考试中显示出较高的同时效度。该测试可以作为临床课程形成性和总结性测试的一个很好的替代方案。
