摘要：Background: The Script Concordance Test (SCT) has not been reported in summative assessment of students
across the multiple domains of a medical curriculum. We report the steps used to build a test for summative
assessment in a medical curriculum.
Methods: A 51 case, 158-question, multidisciplinary paper was constructed to assess clinical reasoning in 5th-year.
10–16 experts in each of 7 discipline-based reference panels answered questions on-line. A multidisciplinary group
considered reference panel data and data from a volunteer group of 6th Years, who sat the same test, to determine
the passing score for the 5th Years.
Results: The mean (SD) scores were 63.6 (7.6) and 68.6 (4.8) for the 6th Year (n = 23, alpha = 0.78) and and 5th Year
(n = 132, alpha =0.62) groups (p < 0.05), respectively. The passing score was set at 4 SD from the expert mean. Four
students failed.
Conclusions: The SCT may be a useful method to assess clinical reasoning in medical students in multidisciplinary
summative assessments. Substantial investment in training of faculty and students and in the development of
questions is required.
