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Table 1 An example of a SCT case vignette with two questions

From: Summative assessment of 5thyear medical students’ clinical reasoning by script concordance test: requirements and challenges

  If you are considering the following investigation … and then you find … you would then consider the proposed investigation to be …
Q1 A ventilation-perfusion scan to rule out pulmonary embolism Her chest X-ray demonstrates areas of collapse much less useful
    slightly less useful
    neither less nor more
    useful
    slightly more useful
    much more useful
Q2 An arterial blood gas Her oxygen saturation whilst breathing room air is 96% much less useful
    slightly less useful
    neither less nor more useful
    slightly more useful
    much more useful
  1. The information in each question stands alone – i.e. when considering the answer to Q2 there is no chest X-ray result available and for Q1 there is no oxygen saturation result available. Typically, between 3-5 questions are provided per clinical case.
  2. You are called to a hospital ward to evaluate a 74-year-old woman five days following open cholecystectomy. She is complaining of a sore leg and now feels short of breath whilst sitting in a chair.