Book/Other Types of Test Items

Script Concordance Test (SCT)

The item begins with a text similar to the one in an SBA. This is followed by a question that both offers a possible solution (hypothesis), and also brings new information and asks to what extent the new information supports the proposed hypothesis. The test taker usually chooses an answer from five options (from the hypothesis being very unlikely to the hypothesis being very likely).

Example:

You are examining a 14-month-old Holstein heifer who is bloated and anorexic. Her body temperature is 39.5 °C, heart rate 115 beats/min., respiratory rate 64/min. She is not dehydrated, rumen contractions are inaudible, there is very little excrement.

If you are considering dislocation of the spleen to the left as a possible cause, and in the laboratory finding fibrinogen is 10 g/l, this cause becomes

-2 very unlikely

-1 less likely

0 neither less nor more probable

1 more likely

2 very likely

A vignette is often followed by several questions:

You are examining a 48-year-old man with Fournier's gangrene who has repeatedly undergone surgical removal of necrotic tissue. The patient is treated with broad-spectrum antibiotics.

If you were planning to...	...and found out that…	the planned solution is
1. skin transplantation for a scrotal defect	in part of the defect there is granulation tissue, but the disease continues to progress to the groin, where there are new necrotic areas,	-2: absolutely contraindicated -1: relatively contraindicated 0: equally indicated or contraindicated 1: indicated 2: highly indicated
If you were planning to...	...and found out that…	the planned solution is
2. further debridement	the patient is septic, intubated, cardiopulmonarily unstable,	-2: absolutely contraindicated -1: relatively contraindicated 0: equally indicated or contraindicated 1: indicated 2: highly indicated
If you were planning to...	...and found out that…	the planned solution is
3. hyperbaric oxygen therapy	the patient is septic, intubated, cardiopulmonary unstable,	-2: absolutely contraindicated -1: relatively contraindicated 0: equally indicated or contraindicated 1: indicated 2: highly indicated

The scoring of the answers is determined separately for each question, based on the opinion of a group of experts. Each expert marks one option that they consider to be correct. The option marked by the largest number of experts (the so-called modal option) is scored with the full number of points. Scores for other options are assigned by relationship

[Score for possibility] = [number of experts that have marked this option] / [number of experts that have marked the modal option]

For example:

The item was evaluated by 10 experts. They marked the correct options as follows:

Option	-2	-1	0	1	2
The number of experts that have marked the option as correct	0	0	2	5	3

The modal option is the answer "1", which was marked by the largest number of experts – so this option will be awarded full points. The full scoring will look like this:

Option	-2	-1	0	1	2
Score for option	0/5 = 0	0/5 = 0	2/5 = 0,4	5/5 = 1	3/5 = 0,6