Background: Clinical reasoning is defined as the applying knowledge and expertise for solving clinical problems. This ability has the major role in physician abilities in diagnosis and management of diseases. One of the major methods in clinical reasoning assessment is SCT. In this study we used script concordance test in internal medicine department. The major aim of this study is to measure psychometric qualities of SCT and determining correlation between this test and routine MCQ in internal medicine department of Shiraz medical school.
Methods: In this study 100 interns participated. Beside the routine multiple question exams taken from the students at the end of the department semester, 20 SCT questions were given to the students and they were asked to answer these questions carefully. The subjects of the questions included basic and important areas of internal medicine. The reliability, item difficulty, item discrimination, item total correlation and correlation between SCT and MCQ test was measured.
Results: The mean score of student in SCT was 11.2/20, in MCQ 14.32/20, item difficulty was 0.3-0.8, item discrimination (0.02-0.27), item total correlation was 0.04-0.6, correlation between SCT and MCQ was 0.3 and reliability of SCT was 0.71 and reliability for MCQ was 0.82.
Discussion: The result of this study showed that correlation between SCT and MCQ was intermediate. This finding emphasizes that clinical reasoning tests measures examinees’ abilities in clinical decision making and problem solving while MCQs measure the examinees’ knowledge. The result of reliability of SCT, item discrimination, item difficulty and item total correlation showed that this test may be used as a substituted of MCQ in clinical wards as a better measure for clinical reasoning skill.