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

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

	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

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.
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.

ISSN: 1472-6920