Assessing clinical reasoning skills using Script Concordance Test (SCT) and extended matching questions (EMQs): A pilot for urology trainees

Introduction: Clinical reasoning skill is the core of medicalcompetence. Commonly used assessment methods for medicalcompetence have limited ability to evaluate critical thinking andreasoning skills. Script Concordance Test (SCT) and ExtendedMatching Questions (EMQs) are the evolving tests which areconsidered to be valid and reliable tools for assessing clinicalreasoning and judgment. We performed this pilot study to determinewhether SCT and EMQs can differentiate clinical reasoning abilityamong urology residents, interns and medical students.Methods: This was a cross-sectional study in which an examinationwith 48 SCT-based items on eleven clinical scenarios and four themedEMQs with 21 items were administered to a total of 27 learners atthree differing levels of experience i.e. 9 urology residents, 6 internsand 12 fifth year medical students. A non-probability conveniencesampling was done. The SCTs and EMQs were developed fromclinical situations representative of urological practice by 5 contentexperts (urologists) and assessed by a medical education expert.Learners’ responses were scored using the standard and the graduatedkey. A one way analysis of variance (ANOVA) was conducted tocompare the mean scores across the level of experience. A p-valueof