Impact of panelists’ experience on script concordance test scores of medical students

Abstract

Background The evaluation process of French medical students will evolve in the next few years in order to improve assessment validity. Script concordance testing (SCT) offers the possibility to assess medical knowledge alongside clinical reasoning under conditions of uncertainty. In this study, we aimed at comparing the SCT scores of a large cohort of undergraduate medical students, according to the experience level of the reference panel. Methods In 2019, the authors developed a 30-item SCT and sent it to experts with varying levels of experience. Data analysis included score comparisons with paired Wilcoxon rank sum tests and concordance analysis with Bland & Altman plots. Results A panel of 75 experts was divided into three groups: 31 residents, 21 non-experienced physicians (NEP) and 23 experienced physicians (EP). Among each group, random samples of N = 20, 15 and 10 were selected. A total of 985 students from nine different medical schools participated in the SCT examination. No matter the size of the panel (N = 20, 15 or 10), students’ SCT scores were lower with the NEP group when compared to the resident panel (median score 67.1 vs 69.1, p < 0.0001 if N = 20; 67.2 vs 70.1, p < 0.0001 if N = 15 and 67.7 vs 68.4, p < 0.0001 if N = 10) and with EP compared to NEP (65.4 vs 67.1, p < 0.0001 if N = 20; 66.0 vs 67.2, p < 0.0001 if N = 15 and 62.5 vs 67.7, p < 0.0001 if N = 10). Bland & Altman plots showed good concordances between students’ SCT scores, whatever the experience level of the expert panel. Conclusions Even though student SCT scores differed statistically according to the expert panels, these differences were rather weak. These results open the possibility of including less-experienced experts in panels for the evaluation of medical students.

Script concordance test acceptability and utility for assessing medical students’ clinical reasoning: a user’s survey and an institutional prospective evaluation of students’ scores

“…Similarly to our results, some studies reported that SCT scores also appeared correlated with those obtained on classical MCQ tests for undergraduate students [ 12 ]. In addition, recent large studies carried out within French faculties have confirmed the utility of SCT in the current context with good acceptability from the students' point of view and without any pejorative arguments from the teachers' point of view [ 12 , 33 ].…”

Educators and practitioners’ perspectives in the development of a learning by concordance tool for medical clerkship in the context of the COVID pandemic

“…In this case, it could be better to have panelists with fewer years of experience or with a more general practice. Peyrony et al 25 explored the SCT scores of undergraduate medical students (n = 985) according to the experience level of the reference panel. A panel of 75 experts was divided into three groups: 31 residents, 21 non experienced physicians and 23 experienced physicians.…”

“…The possibility of having panelists with less than five years of experience was well accepted when the examinees were undergraduate medical students. 25 When the SCT was designed for more experienced examinees such as residents in a broad specialty, such as general surgery or internal medicine, it could be better to have subspecialty-specific experts. 26 This latter recommendation was based on the results of a study by Petrucci et al 26 aiming to determine whether a specialty-specific scoring key improves the validity of the SCT.…”

“…26 This latter recommendation was based on the results of a study by Petrucci et al 26 aiming to determine whether a specialty-specific scoring key improves the validity of the SCT. While Peyrony et al 25 and Petrucci et al 26 focused on SCT, further studies probing the variety of panelist profiles would help to better understand their educational contribution to an LbC tool.…”

Professionalism and clinical short answer question marking with machine learning

“…Marking of the written questions was undertaken by junior medical officers and senior medical students who had passed their final examinations. The marking of examinations by senior medical students and junior medical officers is a routine approach at certain centres, and has been demonstrated to be effective in a variety of examination formats 11,12 . If an answer was considered reasonable, but was not addressed by the predefined marking criteria, consensus was reached through group discussion.…”