Zavaleta-Hernández S, Cerón-Rodríguez M, Olivar-López V, Espinoza-Montero R, Rizzoli-Córdoba A

Language: English
References: 10
Page: 369-373
PDF size: 317.39 Kb.

Text Extraction

Background. Clinical reasoning is a crucial skill to be acquired during a residency training program. In pediatric emergency medicine, physicians are challenged by diagnostic, investigative, and treatment uncertainties. The Script Concordance Test (SCT) uses authentic clinical scenarios to compare trainee’s judgement skills with those of experts. The purpose of this study was to evaluate the clinical reasoning using a pediatric emergency medicine SCT and to determine if it would be able to differentiate between different levels of residency training, validating it in Mexico.
Methods. A SCT containing 58 questions nested in 14 cases was administered to pediatric and senior residents at one academic institution. Fourteen experienced emergency medicine pediatricians were part of a reference panel to establish the basis for the scoring process.
Results. Ninety six residents consented to participate. Thirteen residents were fellows of pediatric intensive care medicine or pediatric emergency medicine, and there were 83 pediatric residents. Overall, there was a significant difference in performance across levels of training. The difference between all levels was significant.
Conclusions. This pediatric emergency medicine Script Concordance Test was useful to assess the progression of clinical reasoning during residency training in Mexico.

REFERENCES

1. Carriere B, Gagnon R, Charlin B, Downing S, Bordage G. Assessing clinical reasoning in pediatric emergency medicine: validity evidence for a Script Concordance Test. Ann Emerg Med 2009;53:647-652.

2. Hudle TS, Heudebert GR. Taking apart the art: the risk of anatomizing clinical competence. Acad Med 2007;82:536-541.

3. Bandiera GW, Morrison LJ, Regehr G. Predictive validity of the Global Assessment Form used in a final-year undergraduate rotation in emergency medicine. Acad Emerg Med 2002;9:889-895.

4. Gray JD. Global rating scales in residency education. Acad Med 1996;71(suppl 1):S55-S63.

5. Schmidt HG, Norman GR, Boshuizen HP. A cognitive perspective on medical expertise: theory and implication. Acad Med 1990;65:611-621.

6. Charlin B, Boshuizen HP, Custers EJ, Feltovich PJ. Scripts and clinical reasoning. Med Educ 2007;41:1178-1184.

7. Lubarsky S, Chalk C, Kazitani D, Gagnon R, Charlin B. The Script Concordance Test: a new tool assessing clinical judgement in neurology. Can J Neurol Sci 2009;36:326-331.

8. Fournier JP, Desmeester A, Charlin B. Script Concordance Tests: guidelines for construction. BMC Med Inform Decis Mak 2008;8:e18. doi:10.1186/1472-6947-8-18.

9. Charlin B, Roy L, Brailovsky C, Goulet F, van der Vleuten C. The Script Concordance Test: a tool to assess the reflective clinician. Teach Learn Med 2000;12:189-195.

10. Piovezan RD, Custodio O, Cendoroglo MS, Batista NA. Script Concordance Test: an approach to the evaluation of clinical reasoning in uncertain contexts. Rev Bras Educ Med 2010;34:5-12.