Construction and utilization of a script concordance test as an assessment tool for dcem3 (5th year) medical students in rheumatology

Table 2 Examples of vignettes with diagnostic and treatment questions used in the script concordance test in rheumatology

• Mrs. Pervenche, 52 years old, consults for pain and inflammation in both wrists and in the two second MCPs for the past 2 months. You find synovitis in these four joints.
If you were thinking of…	And then if you were to find…	This hypothesis would become:
Making a diagnosis of rheumatoid arthritis	Negative for rheumatoid factor and anti-CCP antibodies
Making a diagnosis of rheumatoid arthritis	A line of chondrocalcinosis on radiographs of the hand at the level of the triangular carpal ligament
• Mr Xavier, 68 years old, comes in for his first viscosupplementation injection in the left knee. He is on oral anticoagulants for atrial fibrillation.
If you were thinking of…	And then if you were to find…	This hypothesis would become:
Administering the injection	Previous day’s INR of 2.9

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