Clinical reasoning evaluation using script concordance test in primary care residents

Abstract

INTRODUCTION: Actual unawareness about paediatric resident's residency program factual clinical reasoning precludes professional retraining directed to solve deficiencies. Script Concordance Test (SCT) evaluates clinical reasoning due to its orientation to usual clinical practice but surprisingly it has not been used in Spain for Paediatric Primary Care clinical reasoning evaluation so far. Due to this we consider it to be of relevance to design a Paediatric Primary Care SCT which meets validity, reliability and accessibility criteria described on bibliography. METHODS: Development, validation and application of an SCT questionnaire for clinical reasoning analysis in Paediatric Primary Care applied on a population of paediatric residents and which includes demographic and employment data in order to study possible relationship between them and achieved scores. RESULTS: Our SCT was approved by an experts committee. It met reliability and accessibility criteria and it allowed distinguishing experts from paediatric internal residents. No statistically significant differences were found concerning age, gender, type and duration of the training received in Primary Care, and the completion of a course on that training. CONCLUSIONS: We developed a SCT that was approved by a Paediatric experts committee, it met reliability and accessibility criteria and it allowed distinguishing clinical reasoning from experts and paediatric internal residents. Except second year residency program, we didn't objectified relevant differences in residency program year, age, gender, duration and realization of Paediatric Primary Care rotation, and training course realization.