Kaur Mandeep, Singla Shweta, Mahajan Rajiv
Department of Pharmacology, Adesh Institute of Medical Sciences & Research, Bathinda, Punjab, India.
J Adv Med Educ Prof. 2020 Jul;8(3):115-120. doi: 10.30476/jamp.2020.85163.1168.
Script concordance test (SCT) is an innovative tool to teach and assess the clinical reasoning skills of medical students. It is the key aspect of clinical competency that enables the medical graduates to progress from novice to practicing general practitioner. SCT was used the first time in pharmacology to inculcate clinic reasoning skills in medical students by focusing on the topic of pharmacotherapy.
A SCT with a total of 18 questions, with 15 questions having 3 items each, one having four items and two questions having two items each was administered to 170 second year undergraduate medical students in the subject of pharmacology to assess the clinical reasoning skills. It was an interventional study conducted using convenience sampling technique with a sample size of 170. Aggregate scoring method was used to do the scoring obtained from the answers given by 10 expert-panel members in the field of pharmacology, which were used as an answer key to do the final scoring of the students. Descriptive statistics were computed using Students t test. SCT conduct included a small-group feedback session to the students post-SCT. A feedback questionnaire was administered to the students one week after the feedback session. Reliability of the SCT and feedback questionnaire was checked by calculating Cronbach alpha through Siegle reliability calculator. Content validity of the test as well as feedback questionnaire was done by the panel of experts included in the study.
Though the mean score of the students (27.68±4.59) was significantly lower than the expert panel (40.91±3.52), students were highly satisfied as they expressed that SCT enhanced their perceived clinical reasoning skills (median value=5) and critical thinking (median value=4). The Cronbach alpha for the test was 0.76. The students were also highly satisfied with the feedback given by the teachers after the SCT (median value=4).
SCT enhances critical thinking and clinical reasoning skills of the students, as reported by them. With the conduct of feedback session post-SCT, it can be used as assessment for learning tool and can be well used in a para-clinical subject of pharmacology.
脚本一致性测试（SCT）是一种用于教授和评估医学生临床推理技能的创新工具。它是临床能力的关键方面，能使医学毕业生从新手成长为执业全科医生。SCT首次在药理学中使用，通过聚焦药物治疗主题向医学生灌输临床推理技能。
对170名药理学专业本科二年级学生进行了一项SCT，共18道题，其中15道题每题有3个选项，1道题有4个选项，2道题每题有2个选项，以评估他们的临床推理技能。这是一项采用便利抽样技术的干预性研究，样本量为170。采用汇总评分法，由10名药理学领域的专家小组成员对学生的答案进行评分，这些评分用作学生最终得分的答案密钥。使用学生t检验计算描述性统计量。SCT实施包括在测试后为学生提供小组反馈环节。在反馈环节一周后向学生发放反馈问卷。通过使用Siegle可靠性计算器计算克朗巴哈系数来检查SCT和反馈问卷的可靠性。测试以及反馈问卷的内容效度由研究中纳入的专家小组完成。
尽管学生的平均得分（27.68±4.59）显著低于专家小组（40.91±3.52），但学生们非常满意，因为他们表示SCT提高了他们的临床推理技能（中位数=5）和批判性思维（中位数=4）。该测试的克朗巴哈系数为0.76。学生们对SCT后教师提供的反馈也非常满意（中位数=4）。
如学生所述，SCT提高了他们的批判性思维和临床推理技能。通过在SCT后进行反馈环节，它可以用作学习评估工具，并可很好地应用于药理学这一旁临床学科。
