Development and psychometrics of script concordance test (SCT) in midwifery

Abstract

Background: 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. Methods: 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. Results: 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. Conclusion: 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.

How to develop clinical reasoning in medical students and interns based on illness script theory: An experimental study

“…Clinical reasoning is a mental process that plays an important role in the accurate diagnosis and management of diseases (20,21). The aim of this study was to investigate the impact of educational strategies inspired by script theory in the development of illness scripts.…”

Teaching clinical reasoning to undergraduate medical students by illness script method: a randomized controlled trial

“…The SCT assesses illness scripts' formation in medical students by comparing their answers on this test to a panel of experts' responses. In our previous studies, SCT has been described as a valid and reliable assessing tool in the clinical reasoning field [24][25][26][27]. Compared to other studies, we had performed SCT 4 weeks after original workshops, which helped to understand retention of knowledge for some time compared to the immediate posttest, which was better in the intervention group than the control group.…”

Web-based competency test model for midwifery students

“…Competency Test is a form of self-evaluation of students and universities in improving the education process, quality assurance of graduates, implementation of curriculum, and sharpening the relevance of competencies following competency standards desired by professions and service users (Delavari et al, 2018;Ministry of Education, 2020;Ministry of Research and Technology, 2019). Competency Test is organized by universities in collaboration with Midwives Professional Organization, health worker training institutions, or accredited health professional certification bodies.…”