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首页> 外文期刊>Perspectives on Medical Education >The script concordance test: an adequate tool to assess clinical reasoning?
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The script concordance test: an adequate tool to assess clinical reasoning?

机译：脚本一致性测试：评估临床推理的适当工具？

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In this issue of Perspectives on Medical Education, Lubarsky et??al. investigate the possibility that test takers can obtain artificially inflated test scores on the Script Concordance Test (SCT) by strategically selecting options, rather than by using their knowledge to arrive at the correct answer [1]. The Script Concordance Test is a??test to assess clinical reasoning, consisting of items that require students to judge the change in likelihood of a??diagnostic hypothesis (provided to them) given a??new piece of information (also provided to them) on a??five-point Likert scale, ranging from a??2 ([almost] rules out the hypothesis) through??0 (does not change its likelihood) to +2 (hypothesis now [almost] certain) [2]. For each item, the test takersa?? response is compared with the composite judgment of a??panel of experts, and credit points are assigned in accordance with the proportion of experts selecting the same response when test norms are constructed. If the testee selects the same response as the majority of experts, he/she obtains the maximum number of credit points. If the testee sides with a??minority of experts, points are detracted. Otherwise, no points are awarded at all. By running a??simulation, Lubarsky and colleagues [1] demonstrate that test takers who consistently choose the a??0a?? option (no change in likelihood) can artificially inflate their scores from a??2.1??SD below the average of an actual sample of respondentsa??the score obtained by random guessing,a??to a??0.7??SD below this average. It may be argued that this form of a??gaming the testa?? by consistently selecting the a??0a?? option is contrived. In fact, it is an inevitable consequence of using a??computer simulation, which only enables investigation of formal, knowledge-free gaming strategies. However, it makes sense to assume a??tendency among human test takers to select a??0a?? on items for which they lack the knowledge, or do not feel confident, because this appears to be the least risky option, which will fairly often yield some points. Participants with relatively little knowledge can exploit this a??strategya?? by answering only the few questions they are confident they know, selecting the a??0a?? on all other questions. This way, they might succeed in elevating their score to well above the a??0.7??SD level. Thus, the authorsa?? recommendation to restrict the number of SCT items for which a??0a?? is the correct answer seems to be defensible, even if no human test taker will ever consistently choose the a??0a?? on all SCT items.
机译：在本期《医学教育观点》中，Lubarsky等人。通过策略性地选择选项，而不是通过使用他们的知识来得出正确答案，来研究应试者在Script Concordance Test（SCT）上获得人为夸大的考试成绩的可能性[1]。脚本一致性测试是一项评估临床推理的测试，包括要求学生在给定新信息（也提供给他们）的情况下判断（提供给他们）诊断假设可能性的项目。 ）在五点李克特量表上，范围从a ?? 2（[几乎]排除了假设）到?? 0（不改变其可能性）到+2（现在[几乎]确定）[2 ]。对于每个项目，应试者？将响应与专家小组的综合判断进行比较，并在构建测试规范时根据选择相同响应的专家比例来分配学分。如果被测者选择的答案与大多数专家相同，则他/她将获得最大的信用点数。如果被测者与少数专家在一起，那么分数就被贬低了。否则，将不会获得任何积分。通过运行a？模拟，Lubarsky及其同事[1]演示了始终选择a？0a？的应试者。选择权（可能性不变）可以人为地将他们的分数从低于受访者实际样本平均水平的a ?? 2.1 ?? SD扩展到a？通过随机猜测获得的得分，a ??到低于0.7？SD这个平均值。可能有人争辩说，这种“游戏遗嘱”的形式通过始终选择a ?? 0a ??选项是人为设计的。实际上，这是使用计算机模拟的必然结果，它只能研究形式化的，无知识的游戏策略。然而，假设在人类应试者中选择“ 0a”是有意义的。在他们不了解或不自信的物品上，因为这似乎是风险最小的选择，通常会得出一些观点。知识相对较少的参与者可以利用此策略？通过只回答他们有信心知道的几个问题，选择a ?? 0a ??。在所有其他问题上。这样，他们可以成功地将分数提高到远高于a ?? 0.7 ?? SD的水平。因此，作者？建议限制a ?? 0a ??的SCT项目的数量即使没有人类应试者会始终选择a ?? 0a ??，正确答案似乎也是可以辩解的。在所有SCT项目上。

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