Is the script concordance test a valid instrument for assessment of intraoperative decision-making skills?

摘要: Background: Intraoperative decision making requires both knowledge and experience. The script concordance test (SCT), based on cognitive psychology theory, is a new tool of clinical-reasoning assessment that may be used to evaluate candidate’s approach ill-defined problems encountered in the operating room. Methods: To develop validate an SCT for intraoperative making. One hundred questions were prepared objectives residency training American Board Surgery. These reviewed face content validity by 3 board-certified general surgeons. was administered 36 surgical residents ranging from R1 R5. scoring grid obtained giving 10 surgeons who completed independently. Aggregate used. After question optimization, final statistical analysis composed 62 questions. Results: had excellent reliability (Cronbach , .85). Scores increased with higher levels except small decrease R5 scores (R1, 52.5 9.9; R2, 62.4 5.1; R3, 68.3 9.2; R4, 75.7 9.6; R5, 68 6.4) There significant difference between junior (R1 R2) senior (R3 R4 R5) residents: 56.8 9.5 versus 70.2 8.8 (P .0001). Conclusions: SCT, applied clinical judgment, can discriminate successfully residents. Results must compared present gold standard, oral examination, better determine its place as tool. © 2007 Excerpta Medica Inc. All rights reserved.