Evaluating script concordance tests (SCTs) through the lens of Bayesian reasoning: Enhancing assessment in medical education - 23/01/25

Highlights |
• | Script Concordance Tests (SCTs), which have been included in the 2024 French National Ranking Examinations (EDN), aim to assess students’ clinical reasoning under uncertainty. |
• | The concept of SCT aligns with Bayesian probability, updating the likelihood of hypotheses based on new information, emphasizing their pedagogical value. |
• | Key ambiguities include the specific clinical reasoning stage being evaluated, appropriate Likert scale labels, and the suitability of expert panels as benchmarks. |
• | Addressing these ambiguities could enhance the effectiveness of SCTs, improve medical education, and offer a rich research avenue for refining clinical practice. |
Abstract |
Background |
Script Concordance Tests (SCTs) represent an innovative assessment method which have been introduced in the 2024 French National Ranking Examinations (EDN). These tests compare a student's clinical reasoning with that of a panel of experts under conditions of uncertainty. Typically, the question involves the impact of new information on an initially proposed hypothesis, with answers given on a Likert scale.
Main findings |
This article aims to didactically illustrate how SCTs are consistent with probabilistic reasoning as modeled by Bayes' theorem. In addition, by comparing SCT writing guidelines with Bayesian reasoning concepts, several ambiguities were identified: (1) What stage of clinical reasoning do SCTs evaluate? (2) What are the appropriate labels for Likert scale responses? (3) Does the expert panel provide a relevant reference for SCTs?
Conclusions |
Currently, many of these questions remain unanswered in the literature, with recent data suggesting that experienced physicians' responses to SCTs are often biased. Beyond their use as an assessment tool in the EDN, SCTs offer a valuable opportunity to develop and deepen the teaching of probabilistic reasoning in medical education and serve as a potential area of research to improve clinical practice.
Le texte complet de cet article est disponible en PDF.Keywords : Script concordance test, SCT, Clinical reasoning, Probabilistic reasoning, Bayesian reasoning
Plan
Vol 73 - N° 1
Article 202804- février 2025 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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