Reliability and validity of the script concordance test for postgraduate students of general practice

Background: The script concordance test (SCT) is a validated method of examining students’ clinical reasoning. Medical students’ professional skills are assessed during their postgraduate years as they study for a specialist qualification in general practice. However, no specific provision is made for assessing their clinical reasoning during their postgraduate study. Objective: The aim was to demonstrate the reliability and validity of the SCT in general practice and to determine if this tool could be used to assess medical students’ progress in acquiring clinical reasoning. Methods: A 135-question SCT was administered to postgraduate medical students at the beginning of their first year of specialized training in general practice, and then every six months throughout their three-year training, as well as to a reference panel of 20 expert general practitioners. For score calculation, we used the combined scoring method as the calculator made available by the University of Montreal’s School of Medicine in Canada. For the validity, student’ scores were compared with experts, p <.05 was considered statistically significant. Results: Ninety students completed all six assessments. The experts’ mean score (76.7/100) was significantly higher than the students’ score across all assessments (p <.001), with a Cronbach’s alpha value of over 0.65 for all assessments. Conclusion: The SCT was found to be reliable and capable of discriminating between students and experts, demonstrating that this test is a valid tool for assessing clinical reasoning skills in general practice.