Script concordance tests production optimization using enhanced interactive training: randomized, single-blind, bicentric trial

BACKGROUND: The Script Concordance Test (SCT) is an effective tool for clinical reasoning assessment. However, many faculty members are still unfamiliar with this modality, and there are challenges in recruiting panelists who are mandatory for the assessment of SCT. The aim of this study was to assess the benefits of providing training in the quality of SCTs produced by junior faculties members. METHODS: This was a randomized, single-blind, two-centre trial. The intervention consisted of 2 h of interactive training. The primary outcome was a comparison of the percentage of post-intervention valid SCT between the trained and the control group. The secondary outcome was to determine the factors associated with the quality of SCT. RESULTS: In two medical schools in the Paris area, 115 participants were recruited in February 2024; they produced 460 SCT. Nine panels of experts were assembled. The percentage of post-intervention valid SCTs was significantly higher in the trained group (41% versus 16%, p < 0.001). This was confirmed in a sensitivity analysis performed on all the SCTs, adjusted for unbalanced variables between the two randomization arms ("risk" of producing a valid SCT when the participants were in the trained arm: aOR 2.53 [1.57; 4.13], p < 0.001). CONCLUSION: Our prospective randomized study suggested the significant benefits for inexperienced physicians of an initial training in SCT writing quality.