FonoTCS: validação de uma ferramenta para avaliação do raciocínio clínico em Fonoaudiologia
FonoTCS: validation of a tool for assessing clinical reasoning in Speech-Language pathology
Ana Cristina Côrtes Gama; Roberto da Costa Quinino; Adriane Mesquita Medeiros; Patrícia Cotta Mancini; Aline Mansueto Mourão; Lara Gama Santos; Thais Helena Machado; Nayara Ribeiro Gomes
Resumo
Palavras-chave
Abstract
Purpose To validate the internal structure of the Speech-Language Pathology Script Concordance Test (FonoTCS), which will be developed in a virtual, open-access format, to be used in the assessment of clinical reasoning among young professionals and students of speech-language pathology with a generalist background, speakers of Brazilian Portuguese.
Methods This is a study to validate the internal structure of the instrument. Twenty-five specialist speech-language pathologists, with more than 10 years of generalist clinical experience, and 35 students summoned for Enade participated. Both groups evaluated the 30 clinical cases with 120 items from FonoTCS. For the final selection of specialists who made up the sample, judges whose evaluations showed Z2 results >2 and Z<-2 distant from the modal response were removed. For the selection of items present in the final format of the test, those that remained had a Pearson correlation between the transformed scores of students for a given item and the sum of the transformed scores for all items, with a value greater than 0.05. The Cronbach's Alpha test was applied to measure the internal consistency of FonoTCS, and the score of each item was defined based on the aggregated score method.
Results The responses of 13 specialists were considered for the definition of the final test score. The final instrument had 88 items distributed across 28 clinical cases. The internal consistency was 0.903 with a 95% confidence interval expressed by 0.86|---|0.95. These values indicate a high internal consistency among the items of FonoTCS.
Conclusion FonoTCS is valid and reliable for use in evaluating the clinical reasoning of young professionals and speech-language pathology students with generalist training, who are Brazilian Portuguese speakers.
Keywords
Referências
1 Newble D, Norman G, Van der Vleuten C. Assessing clinical reasoning. In: Jones JHM, editor. Clinical reasoning in the health professions. 2nd ed. Oxford: Butterworth Heinemann; 2000. p. 156-68.
2 Young ME, Thomas A, Lubarsky S, Gordon D, Gruppen LD, Rencic J, et al. Mapping clinical reasoning literature across the health professions: a scoping review. BMC Med Educ. 2020;20(1):107.
3 Nalini YC, Manivasakan S, Pai DR. Comparison between MCQ, Extended matching questions (EMQ) and Script concordance test (SCT) for assessment among first-year medical students: a pilot study. J Educ Health Promot. 2024;13(1):52.
4 Charlin B, Tardif J, Boshuizen HP. Scripts and medical diagnostic knowledge: theory and applications for clinical reasoning instruction and research. Acad Med. 2000;75(2):182-90.
5 Charlin B, Roy L, Brailovsky C, Goulet F, van der Vleuten C. The Script Concordance test: a tool to assess the reflective clinician. Teach Learn Med. 2000;12(4):189-95.
6 Fong JMN, Hoe RHM, Huang DH, Wong JC, Kee JXL, Teng KLA, et al. Script concordance test to assess clinical reasoning in acute medicine. Ann Acad Med Singap. 2023;52(7):383-5.
7 Redmond C, Jayanth A, Beresford S, Carroll L, Johnston ANB. Development and validation of a script concordance test to assess biosciences clinical reasoning skills: a cross-sectional study of 1st year undergraduate nursing students. Nurse Educ Today. 2022;119:105615.
8 Vital S, Wulfman C, Girard F, Tamimi F, Charlin B, Ducret M. Script concordance tests: a call for action in dental education. Eur J Dent Educ. 2021;25(4):705-10.
9 O’Brien SR, Dillon N, Linsky M, Lagueras K, Uhl J, Conroy S, et al. Initial validation of a script concordance test to measure the development of clinical reasoning among physical therapy residents. J Clin Educ Phys Ther. 2023;5:1-9.
10 Silva Ríos AP, Campo Rivas MND, Kuncar Uarac PK, Calvo Sprovera VA. Reliability of a script agreement test for undergraduate speech-language therapy students. CoDAS. 2023;35(5):e20220098.
11 AERA: American Educational Research Association. APA: American Psychological Association. NCME: National Council on Measurement in Education. Joint Committee on Standards for Educational and Psychological Testing. Standards for educational and psychological testing [Internet]. Washington, D.C.; 2014 [citado em 2024 Jul 9]. Disponível em:
12 Gama ACC, Mourão AM, Medeiros AM, Mancini PC, Machado TH, Santos LG, et al. Teste para avaliação do raciocínio clínico em Fonoaudiologia: validade de conteúdo. CoDAS. 2024;36(4):e20230276.
13 Fournier JP, Demeester A, Charlin B. Script concordance test: guidelines for construction. BMC Med Inform Decis Mak. 2008;8(1):18.
14 Dory V, Gagnon R, Vanpee D, Charlin B. How to construct and implement script concordance tests: insights from a systematic review. Med Educ. 2012;46(6):552-63.
15 Lubarsky S, Dory VR, Duggan P, Gagnon R, Charlin B. Script concordance testing: From theory to practice: AMEE Guide No. 75. Med Teach. 2013;35(3):184-93.
16 See KC, Tan KL, Lim TK. The script concordance test for clinical reasoning: re-examining its utility and potential weakness. Med Educ. 2014;48(11):1069-77.
17 Gagnon R, Lubarsky S, Lambert C, Charlin B. Optimization of answer keys for script concordance testing: should we exclude deviant panelists, deviant responses, or neither? Adv Health Sci Educ Theory Pract. 2011;16(5):601-8.
18 Université de Montréal [Internet]. 2024 [citado em 2024 Jul 9]. Disponível em:
19 Charlin B, Gagnon R, Lubarsky S, Lambert C, Meterissian S, Chalk C, et al. Assessment in the context of uncertainty using the script concordance test: more meaning for scores. Teach Learn Med. 2010;22(3):180-6.
20 Wan SH. Using the script concordance test to assess clinical reasoning skills in undergraduate and postgraduate medicine. Hong Kong Med J. 2015;21(5):455-61.
21 Hogan TP. Psychological testing: a practical introduction. 3rd ed. New York: John Wiley & Sons; 2013. 699 p.
22 Gagnon R, Charlin B, Coletti M, Sauve E, van der Vleuten C. Assessment in the context of uncertainty: how many members are needed on the panel of reference of a script concordance test? Med Educ. 2005;39(3):284-91.
23 Kassirer J. Teaching clinical reasoning: case-based and coached. Acad Med. 2010;85(7):1118-24.
24 Mathieu S, Couderc M, Glace B, Tournadre A, Malochet-Guinamand S, Pereira B, et al. Construction and utilization of a script concordance test as an assessment tool for DCEM3 (5th year) medical students in rheumatology. BMC Med Educ. 2013;13(1):166.
25 Ganesan S, Bhandary S, Thulasingam M, Chacko TV, Zayapragassarazan Z, Ravichandran S, et al. Developing script concordance test items in otolaryngology to improve clinical reasoning skills: validation using consensus analysis and psychometrics. Int J Appl Basic Med Res. 2023;13(2):64-9.
26 Omega A, Wijaya Ramlan AA, Soenarto RF, Heriwardito A, Sugiarto A. Assessing clinical reasoning in airway related cases among anesthesiology fellow residents using Script Concordance Test (SCT). Med Educ Online. 2022;27(1):2135421.
27 Charlin B, Van Der Vleuten C. Standardized assessment of reasoning in context of uncertainty. The Script Concordance Test approach. Eval Health Prof. 2004;27(3):304-19.
28 Bland AC, Kreiter CD, Gordon JA. The psychometric properties of five scoring methods applied to the script concordance test. Acad Med. 2005;80(4):395-9.
29 Hudon A, Kiepura B, Pelletier M, Phan V. Using ChatGPT in psychiatry to design script concordance tests in undergraduate medical education: mixed methods study. JMIR Med Educ. 2024;10:e54067.
Submetido em:
09/07/2024
Aceito em:
05/10/2024
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