Kelly Kizner, Jennifer Graebe
Preceptor Development: Using the American Nurses Credentialing Center Outcome-Based Continuing Education Model©
Journal of continuing education in nursing
health professionals often manage medical problems critical situations time pressure basis vague information recent years dual process theory provided framework cognitive processes assist students developing clinical reasoning skills critical especially surgery due high workload elevated stress levels however clinical reasoning skills observed indirectly corresponding constructs difficult measure order assess student performance script concordance test established field number studies suggest test delivers valid assessment clinical reasoning however different scoring methods suggested reflect different interpretations underlying construct work want shed light theoretical framework script theory give idea script concordance testing constructed script concordance test clinical context acute abdomen compared previously proposed scores regard validity test comprising 52 items 18 clinical scenarios developed revised along guidelines administered 56 4th 5th year medical students end blendedlearning seminar scored answers using five different scoring methods distance 2 aggregate 2 single best answer compared scoring keys resulting final scores cronbachs normalization raw scores scores except single best answers calculation achieved acceptable reliability scores 075 measured cronbachs students clearly distinguishable experts whose results set mean 80 sd 5 normalization process two aggregate scoring methods students means values 625 aggpen 639 agg equivalent three expert sd experts mean value cronbachs 076 aggpen 075 agg two distance scoring methods students mean 628 dmode 668 dmean equivalent two expert sd experts mean value cronbachs 077 dmode 079 dmean study single best answer sba scoring key yielded worst psychometric results cronbachs 068 assuming psychometric properties script concordance test scores valid clinical reasoning skills measured reliably different scoring keys sct presented psychometrically distance methods seem superior wherein inherent statistical properties scales might play significant role methodological reasons aggregate methods also used despite limitations complexity underlying scoring process calculation reliability advocate sct allows new perspective measurement teaching cognitive skills