Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/115558
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Type: Journal article
Title: Association between candidate total scores and response pattern in script concordance testing of medical students
Author: Wan, S.
Duggan, P.
Tor, E.
Hudson, J.
Citation: Focus on Health Professions Education, 2017; 18(2):26-35
Publisher: Australian & New Zealand Association for Health Professional Educators (ANZAHPE)
Issue Date: 2017
ISSN: 1442-1100
2204-7662
Statement of
Responsibility: 
S. H. Wan, P. Duggan, E. Tor, J. N. Hudson
Abstract: Introduction: The script concordance test (SCT) aims to test clinical decision making and clinical reasoning. This study is a preliminary attempt to understand an alleged testtaking strategy where students avoid extreme response options, potentially threatening the validity of SCT scores. We investigated whether there is a significant association between the propensity to avoid the extreme response options and candidates’ overall SCT scores. Methods: The SCT scores of 660 clinical-year medical students (six cohorts from 2013–2015) were analysed for a possible association with candidates’ response pattern. The proportion of middle range response options was calculated. Propensity to avoid extreme response options is defined as a response pattern with 15% or more of middlerange responses compared to those of the expert reference panel. The distribution for candidates with propensity to avoid the extreme options was further investigated using chi-square statistics for possible association with their overall SCT results. Results: Fifty-five percent of the students from the lowest quartile, compared to 30% from the top quartile, had shown a propensity to avoid the extreme options. The differences were statistically significant (p < 0.001) and were consistent among all six cohorts included in this study. Conclusions: Students whose SCT scores are in the lowest quartile are more likely to avoid the extreme response options in answering SCT questions. For quality assurance in high stakes summative SCTs, it may be worthwhile to select items with expert reference panel’s modal answers covering the full 5-point response options.
Keywords: Medical education; script concordance; clinical reasoning; assessment
Rights: © ANZAHPE
RMID: 0030079791
DOI: 10.11157/fohpe.v18i2.145
Appears in Collections:Medicine publications

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