ObjectivesTo investigate the construct validity of
Script Concordance Testing (SCT) scores as a measure of the clinical reasoning
ability of medical students and practising General Practitioners with different
levels of clinical experience.MethodsPart I involved a cross-sectional study,
where 105 medical students, 19 junior registrars and 13 experienced General
Practitioners completed the same set of SCT questions, and their mean scores
were compared using one-way ANOVA. In Part II, pooled and matched SCT scores
for 5 cohorts of students (2012 to 2017) in Year 3 (N=584) and Year 4 (N=598)
were retrospectively analysed for evidence of significant progression.
ResultsA significant main effect of clinical
experience was observed [F(2, 136)=6.215, p=0.003]. The mean SCT
score for General Practitioners (M=70.39, SD=4.41, N=13) was significantly
higher (p=0.011) than that of students (M = 64.90, SD = 6.30, N=105). Year 4
students (M=68.90, SD= 7.79, N=584) scored a significantly higher mean score [t(552)=12.78,
p<0.001] than Year 3 students (M = 64.03, SD=7.98, N=598).
ConclusionsThe findings that candidate scores increased
with increasing level of clinical experience add to current evidence in the
international literature in support of the construct validity of Script
Concordance Testing. Prospective longitudinal studies with larger sample sizes
are recommended to further test and build confidence in the construct validity
of SCT scores.