Improving the validity of script concordance testing by optimising and balancing items

摘要

BackgroundA script concordance test (SCT) is a modality for assessing clinical reasoning. Concerns had been raised about the plausible validity threat to SCT scores if students deliberately avoided the extreme answer options to obtain higher scores. The aims of the study were firstly to investigate whether students' avoidance of the extreme answer options could result in higher scores, and secondly to determine whether a balanced approach' by careful construction of SCT items (to include extreme as well as median options as model responses) would improve the validity of an SCT.