Sage Journals: Discover world-class research

Abstract

At present, surgical educators can readily assess knowledge with multiple-choice examinations, and inanimate models can be used to assess technical skills. Clinical judgment and reasoning are indispensable skills used by expert surgeons to solve ill-defined problems encountered in the emergency department, clinic, and operating room. The Script Concordance Test, a new tool of clinical reasoning assessment, can test the elaborated networks of knowledge that experienced surgeons develop over the years. It allows for multiple different approaches to the same problem and could be developed as both a formative and summative assessment tool in general surgery residency programs. This article explores the theoretical and practical aspects of the Script Concordance Test.

Keywords

Clinical reasoning script-concordance surgical residency

Get full access to this article

View all access options for this article.

References

Norman G. Research in clinical reasoning: past history and current trends. Med Educ. 2005;39: 418-427.

Elstein AS , Shulman LS , Sprofka SA. Medical problem-solving: an analysis of clinical reasoning. Cambridge, MA: Harvard University Press, 1978.

Neufeld VR , Norman GR , Feightner JW , Barrows HS. Clinical problem-solving by medical students: a longitudinal and cross-sectional analysis. Med Educ. 1981;5: 315-322.

Proc Annu Conf Res Med Educ. 1983;122-126.

Patel VL , Groen GJ.

Knowledge based solution strategies in medical reasoning

Cogn Sci. 1986;10: 91-115.

Boshuizen HPA , Schmidt HG. Biomedical knowledge and clinical expertise. Cogn Sci. 1992;16: 153-184.

Schmidt HG , Norman GR , Boshuizen HPA. A cognitive perspective on medical expertise: theory implications. Acad Med. 1990;65: 611-621.

Grant J , Marsden P. Primary knowledge, medical education and consultant expertise. Med Educ. 1988;22: 173-179.

Barrows HS , Feltovich PJ. The clinical reasoning process. Med Educ. 1987;21: 86-91.

10.

Papa FJ , Shores JH , Meyer S. Effects of pattern matching, pattern discrimination and experience in the development of diagnostic expertise. Acad Med. 1990;5: 521-522.

11.

Mullen JD , Roth BM. Decision Making: Its Logic and Practice. Savage, MD: Rowman & Littlefield, 1991.

12.

Charlin B , Tardif J , Boshuizen HPA. Scripts and medical diagnostic knowledge: theory and applications for clinical reasoning instruction and research. Acad Med. 75: 182-190, 2000.

13.

Charlin B , Roy L , Brailovsky CA , Goulet F , van der Vleuten C. The Script Concordance test: a tool to assess the reflective clinician. Teach Learn Med. 2000;2: 189-195.

14.

Charlin B , van der Vleuten CPM. Standardized assessment of reasoning in contexts of uncertainty: the script-concordance approach. Eval Health Prof. 2004;27: 304-319.

15.

Brailovsky C , Charlin B , Beausoleil S , Cote S , Van der Vleuten C. Measurement of clinical reflective capacity early in training as a predictor of clinical reasoning performance at the end of residency: an experimental study on the script concordance test. Med Educ. 2001;35: 430-436.

16.

Sibert L , Charlin B , Corcos J , Gagnon R , Grise P , van der Vleuten C. Stability of clinical reasoning assessment results with the script concordance test across two different linguistic, cultural and learning environments. Med Teach. 24: 537-542, 2002.

17.

Brazeau-Lamontagne L , Charlin B , Gagnon R , Samson L , van der Vleuten C. Measurement of perception interpretation skills during radiology training: utility of the script concordance approach. Med Teach. 2002;26: 326-332.

18.

Norman GR. Objective measurement of clinical performance. Med Educ. 1985;19: 43-47.

19.

Norcini JJ , Shea JA , Day SC. The use of the aggregate scoring method for a recertification examination. Eval Health Prof. 1990;13: 241-251.

20.

Dauphinee W. D.

Assessing clinical performance: where do we stand and what might we expect?

JAMA. 1995; 275: 741-743.

21.

Schon DA. The Reflective Practitioner: How Professionals Think in Action. New York, NY: Basic Books; 1983.

22.

Irby D. Editorial. Acad Med. 1997;72: 116-116.

A Novel Method of Assessing Clinical Reasoning in Surgical Residents

Abstract

Keywords

Get full access to this article

References