Introducing recent medical graduates as members of Script Concordance Test expert reference panels: what impact?

The Script Concordance Test (SCT) is being increasingly used in professional development in clinical reasoning, with linear progression in performance in SCT’s observed with increasing clinical experience. One of the limiting factors for the SCT is potential burnout in expert reference panel (ERP) members, which we have attempted to address by the introduction of recent medical graduates as panel members. We sought to evaluate the effect of introducing recent medical graduates in to our ERP’s on pass/fail decisions in the final clinical reasoning examination of the 6-year undergraduate program of the University of Adelaide, Australia. We engaged an ERP comprising 50 faculty members from three collaborating universities and 13 recent medical graduates to answer on line an identical 20 case scenario, 50 question multidisciplinary SCT twice 6 months apart. The questions were used in high stakes end of year assessment of 5 th year medical students (n=132). The pass mark set by the experienced, specialist members of the panel was 49.6% and this increased to 50.4% by addition of recent medical graduates to the panel. This difference would have had no effect on fail rates estimated from the data from the cohort of 132 medical student candidates. In the context of assessment of clinical reasoning in medical programs, recent medical graduates are suitable members of SCT ERP’s, and their contribution can enrich the panel and might help to minimise risk of burnout of more experienced faculty.

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