Impact of panelists' experience on script concordance test scores of medical students.


Journal

BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679

Informations de publication

Date de publication:
17 Sep 2020
Historique:
received: 29 03 2020
accepted: 10 09 2020
entrez: 18 9 2020
pubmed: 19 9 2020
medline: 15 5 2021
Statut: epublish

Résumé

The evaluation process of French medical students will evolve in the next few years in order to improve assessment validity. Script concordance testing (SCT) offers the possibility to assess medical knowledge alongside clinical reasoning under conditions of uncertainty. In this study, we aimed at comparing the SCT scores of a large cohort of undergraduate medical students, according to the experience level of the reference panel. In 2019, the authors developed a 30-item SCT and sent it to experts with varying levels of experience. Data analysis included score comparisons with paired Wilcoxon rank sum tests and concordance analysis with Bland & Altman plots. A panel of 75 experts was divided into three groups: 31 residents, 21 non-experienced physicians (NEP) and 23 experienced physicians (EP). Among each group, random samples of N = 20, 15 and 10 were selected. A total of 985 students from nine different medical schools participated in the SCT examination. No matter the size of the panel (N = 20, 15 or 10), students' SCT scores were lower with the NEP group when compared to the resident panel (median score 67.1 vs 69.1, p < 0.0001 if N = 20; 67.2 vs 70.1, p < 0.0001 if N = 15 and 67.7 vs 68.4, p < 0.0001 if N = 10) and with EP compared to NEP (65.4 vs 67.1, p < 0.0001 if N = 20; 66.0 vs 67.2, p < 0.0001 if N = 15 and 62.5 vs 67.7, p < 0.0001 if N = 10). Bland & Altman plots showed good concordances between students' SCT scores, whatever the experience level of the expert panel. Even though student SCT scores differed statistically according to the expert panels, these differences were rather weak. These results open the possibility of including less-experienced experts in panels for the evaluation of medical students.

Sections du résumé

BACKGROUND BACKGROUND
The evaluation process of French medical students will evolve in the next few years in order to improve assessment validity. Script concordance testing (SCT) offers the possibility to assess medical knowledge alongside clinical reasoning under conditions of uncertainty. In this study, we aimed at comparing the SCT scores of a large cohort of undergraduate medical students, according to the experience level of the reference panel.
METHODS METHODS
In 2019, the authors developed a 30-item SCT and sent it to experts with varying levels of experience. Data analysis included score comparisons with paired Wilcoxon rank sum tests and concordance analysis with Bland & Altman plots.
RESULTS RESULTS
A panel of 75 experts was divided into three groups: 31 residents, 21 non-experienced physicians (NEP) and 23 experienced physicians (EP). Among each group, random samples of N = 20, 15 and 10 were selected. A total of 985 students from nine different medical schools participated in the SCT examination. No matter the size of the panel (N = 20, 15 or 10), students' SCT scores were lower with the NEP group when compared to the resident panel (median score 67.1 vs 69.1, p < 0.0001 if N = 20; 67.2 vs 70.1, p < 0.0001 if N = 15 and 67.7 vs 68.4, p < 0.0001 if N = 10) and with EP compared to NEP (65.4 vs 67.1, p < 0.0001 if N = 20; 66.0 vs 67.2, p < 0.0001 if N = 15 and 62.5 vs 67.7, p < 0.0001 if N = 10). Bland & Altman plots showed good concordances between students' SCT scores, whatever the experience level of the expert panel.
CONCLUSIONS CONCLUSIONS
Even though student SCT scores differed statistically according to the expert panels, these differences were rather weak. These results open the possibility of including less-experienced experts in panels for the evaluation of medical students.

Identifiants

pubmed: 32943030
doi: 10.1186/s12909-020-02243-w
pii: 10.1186/s12909-020-02243-w
pmc: PMC7499961
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

313

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Auteurs

Olivier Peyrony (O)

Department of Emergency Medicine, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris, 1 avenue Claude Vellefaux, 75010, Paris, France. o.peyrony@hotmail.fr.

Alice Hutin (A)

SAMU de Paris, SMUR Necker, Necker Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.

Jennifer Truchot (J)

Department of Emergency Medicine, SMUR, Lariboisère University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Paris Diderot University, Paris, France.

Raphaël Borie (R)

Department of Pneumology, Reference Center for Rare Pulmonary Diseases, Bichat University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
INSERM, UMR 1152, Paris Diderot University, Paris, France.

David Calvet (D)

Department of Neurology and Stroke Unit, Sainte-Anne University Hospital, Paris, France.
INSERM, UMR 1266, Psychiatry and Neurosciences Institute of Paris, Paris-Descartes University, Paris, France.

Adrien Albaladejo (A)

Paris Diderot University, Paris, France.

Yousrah Baadj (Y)

Paris-Descartes University, Paris, France.

Pierre-Emmanuel Cailleaux (PE)

Department of Getriatric Medicine, Louis-Mourier University Hospital, Assistance Publique-Hôpitaux de Paris, F-92700, Colombes, France.
INSERM, UMR 1132, BiOsCar, University of Paris, Paris, France.

Martin Flamant (M)

Department of Kidney Physiology, Bichat University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
INSERM, UMR 1149, Inflammatory Research Center, Paris, France.
University of Paris, Paris, France.

Clémence Martin (C)

Department of Respiratory Medicine, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Cochin Institute, UMR 1016. Paris-Descartes University, Paris, France.

Jonathan Messika (J)

University of Paris, Paris, France.
Pulmonology and Lung Transplant Unit, Bichat University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Physiopathology and Epidemiology of Respiratory Diseases (PHERE), INSERM, UMR 1152, and Paris Transplant Group, Paris, France.

Alexandre Meunier (A)

Paris-Descartes University, Paris, France.

Mariana Mirabel (M)

University of Paris, Paris, France.
Department of Cardio-oncology, Georges Pompidou European University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
INSERM, UMR 970, Paris Cardiovascular Research Center PARCC, Paris, France.

Victoria Tea (V)

Department of Cardiology, Georges Pompidou European University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.

Xavier Treton (X)

University of Paris, Paris, France.
Department of Gastroenterology, Inflammatory Bowel Disease, and Nutritive Assistance, Beaujon University Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, France.

Sylvie Chevret (S)

Department of Biostatistics and Medical Information, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Centre of Research in Epidemiology and StatisticS (CRESS), INSERM, UMR 1153, Epidemiology and Clinical Statistics for Tumor, Respiratory, and Resuscitation Assessments (ECSTRRA) Team, University of Paris, Paris, France.

David Lebeaux (D)

University of Paris, Paris, France.
Department of Microbiology, Mobile Infectiology Unit, Georges Pompidou European University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.

Damien Roux (D)

University of Paris, Paris, France.
Department of Intensive Care, Louis Mourier University Hospital, Assistance Publique-Hôpitaux de Paris, F-92700, Colombes, France.

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