Script Concordance Test in Pharmacology: Maiden experience from a Medical School in India

Script concordance test (SCT) is an innovativetool to teach and assess the clinical reasoning skills of medicalstudents. It is the key aspect of clinical competency that enablesthe medical graduates to progress from novice to practicinggeneral practitioner. SCT was used the first time in pharmacologyto inculcate clinic reasoning skills in medical students by focusingon the topic of pharmacotherapy. A SCT with a total of 18 questions, with 15 questionshaving 3 items each, one having four items and two questionshaving two items each was administered to 170 second yearundergraduate medical students in the subject of pharmacologyto assess the clinical reasoning skills. It was an interventionalstudy conducted using convenience sampling technique with asample size of 170. Aggregate scoring method was used to dothe scoring obtained from the answers given by 10 expert-panelmembers in the field of pharmacology, which were used as ananswer key to do the final scoring of the students. Descriptivestatistics were computed using Students t test. SCT conductincluded a small-group feedback session to the students post-SCT. A feedback questionnaire was administered to the studentsone week after the feedback session. Reliability of the SCT andfeedback questionnaire was checked by calculating Cronbachalpha through Siegle reliability calculator. Content validity of thetest as well as feedback questionnaire was done by the panel ofexperts included in the study. Though the mean score of the students (27.68±4.59) wassignificantly lower than the expert panel (40.91±3.52), studentswere highly satisfied as they expressed that SCT enhanced theirperceived clinical reasoning skills (median value=5) and criticalthinking (median value=4). The Cronbach alpha for the test was0.76. The students were also highly satisfied with the feedbackgiven by the teachers after the SCT (median value=4). SCT enhances critical thinking and clinical reasoningskills of the students, as reported by them. With the conductof feedback session post-SCT, it can be used as assessment forlearning tool and can be well used in a para-clinical subject ofpharmacology.