Trends in the Acquisition of Clinical Reasoning in the Assessment of Speech Sound Disorders: Using the Script Concordance Test

What is already known on this subject? The knowledge base of clinical practitioners includes both content and its organization. Clinical reasoning is the cognitive ability to integrate, organize, and interpret information as a key aspect of expertise in evidence-based practice. Recently, script concordance tests, which use case-based scenarios to reflect clinical decision-making processes, have become a popular method for assessing these reasoning skills. What this paper adds to existing knowledge? This study is the first to empirically show that clinical reasoning skills in speech-language pathology, particularly in assessing speech sound disorders, are progressively refined through clinical experience. It highlights that students' reasoning skills during internships appear to be influenced by supervisory clinical approaches, potentially affecting diagnostic abilities. These reasoning skills may improve with further clinical experience or targeted continuing education. Additionally, the study developed the first SCT focused on SSD evaluation, demonstrating its effectiveness in distinguishing between expert and student clinical reasoning and decision-making abilities. What are the potential or actual clinical implications of this work? A recent goal in clinical education is to make clinical reasoning processes more explicit and structured during training. Creating comprehensive case assessment scripts and designing concrete clinical thinking guidance programs integrated with effective measurement, such as the SCT developed in this study, could serve as teaching objectives for the clinical diagnosis of SSD.