Do Script Concordance Tests Correlate With Family Medicine Standardized Tests and Failing Rotation Grades?

• ClinicalTrials.gov Identifier: NCT03938610
• Recruitment Status: Recruiting
• First Posted: May 6, 2019
• Last Update Posted: July 23, 2020
• Sponsor: Pamela Hughes
• Information provided by (Responsible Party): Pamela Hughes, Mike O'Callaghan Military Hospital

Study Description

Brief Summary:

Delayed or poor identification and remediation of clinical reasoning difficulties can lead to clinician underperformance and can ultimately compromise patient care. To date, no research has been done to see if SCTs correlate with current grading standards (ITE, ABFM certification exam score, ACGME milestones, or failing clinical rotation grades) in Family Medicine Residents. If investigators can identify that an SCT correlates with current standardized testing of Family medicine residents, it could be possible to identify struggling learners prior to poor scores on the ITE, ACGME milestones, or clinical rotations. If a learner does poorly on an SCT early in the academic year the learner can begin a remediation plan to improve their deficits before receiving a failing grade, poor ITE or ACGME milestone scores.

Condition or disease
Knowledge, Attitudes, Practice

Detailed Description:

This study is a longitudinal observation study. A panel of experts (numbering 15-20) consisting of Family Medicine attendings who have been out of residency greater than 3 years will complete the SCT. They will be provided an Informational Consent. Their willingness to be a panel member is their implied consent to be part of the research study.

The basic idea behind SCT is to compare residents' performance with a group of persons who are representatives of the profession (or the specialty) to which they wish to belong. Therefore, panels are made up of physicians with good overall clinical experience in the field rather than experts from narrow parts of the field. Panel composition also depends on the assessment goal.

This study will determine if a Script Concordance Test (SCT) correlates with Family Medicine In Training Exam (ITE) scores, American Board of Family Medicine (ABFM) certification exam scores, Accreditation Council for Graduate Medical Education (ACGME) medical knowledge and patient care milestones, and failing family medicine inpatient clinical rotation grades.

The SCT will be given to PGY1, 2, and 3 residents each year during the Residents three year residency, in June or July.

Study Design

• Study Type: Observational
• Estimated Enrollment: 130 participants
• Observational Model: Cohort
• Time Perspective: Prospective
• Official Title: Do Script Concordance Tests Correlate With Family Medicine Standardized Tests and Failing Rotation Grades?
• Actual Study Start Date: June 1, 2019
• Estimated Primary Completion Date: June 2024
• Estimated Study Completion Date: June 2024

Groups and Cohorts

Outcome Measures

Primary Outcome Measures :

1. SCT scores compared to ITE scores [ Time Frame: year 1 ]
   SCT scores, ranging from 0 to 100 percent, are longitudinal and will be recorded for all PGY1, 2, and 3 subjects enrolled in the study each year of their residency in June or July.
2. SCT scores compared to ITE scores [ Time Frame: year 2 ]
   SCT scores, ranging from 0 to 100 percent, are longitudinal and will be recorded for all PGY1, 2, and 3 subjects enrolled in the study each year of their residency in June or July.
3. SCT scores compared to ITE scores [ Time Frame: year 3 ]
   SCT scores, ranging from 0 to 100 percent, are longitudinal and will be recorded for all PGY1, 2, and 3 subjects enrolled in the study each year of their residency in June or July.
4. SCT scores compared to ABFM scores [ Time Frame: year 1 ]
   SCT scores, ranging from 0 to 100 percent, are longitudinal and will be recorded for all PGY1, 2, and 3 subjects enrolled in the study each year of their residency in June or July.
5. SCT scores compared to ABFM scores [ Time Frame: year 2 ]
   SCT scores, ranging from 0 to 100 percent, are longitudinal and will be recorded for all PGY1, 2, and 3 subjects enrolled in the study each year of their residency in June or July.
6. SCT scores compared to ABFM scores [ Time Frame: year 3 ]
   SCT scores, ranging from 0 to 100 percent, are longitudinal and will be recorded for all PGY1, 2, and 3 subjects enrolled in the study each year of their residency in June or July.
7. SCT scores compared to family medicine rotation grades [ Time Frame: year 1 ]
   SCT scores, ranging from 0 to 100 percent, are longitudinal and will be recorded for all PGY1, 2, and 3 subjects enrolled in the study each year of their residency in June or July.
8. SCT scores compared to family medicine rotation grades [ Time Frame: year 2 ]
   SCT scores, ranging from 0 to 100 percent, are longitudinal and will be recorded for all PGY1, 2, and 3 subjects enrolled in the study each year of their residency in June or July.
9. SCT scores compared to family medicine rotation grades [ Time Frame: year 3 ]
   SCT scores, ranging from 0 to 100 percent, are longitudinal and will be recorded for all PGY1, 2, and 3 subjects enrolled in the study each year of their residency in June or July.
10. SCT scores compared to ACGME milestones. [ Time Frame: year 1 ]
    SCT scores, ranging from 0 to 100 percent, are longitudinal and will be recorded for all PGY1, 2, and 3 subjects enrolled in the study each year of their residency in June or July.
11. SCT scores compared to ACGME milestones. [ Time Frame: year 2 ]
    SCT scores, ranging from 0 to 100 percent, are longitudinal and will be recorded for all PGY1, 2, and 3 subjects enrolled in the study each year of their residency in June or July.
12. SCT scores compared to ACGME milestones. [ Time Frame: year 3 ]
    SCT scores, ranging from 0 to 100 percent, are longitudinal and will be recorded for all PGY1, 2, and 3 subjects enrolled in the study each year of their residency in June or July.
13. Binomial SCT classification derived from each interval SCT scores compared to ACGME milestones. [ Time Frame: year 1 ]
    A "fail" classification is defined as an SCT score 1 SD below the respective PGY mean. All other SCT scores will be classified as "pass".
14. Binomial SCT classification derived from each interval SCT scores compared to ACGME milestones. [ Time Frame: year 2 ]
    A "fail" classification is defined as an SCT score 1 SD below the respective PGY mean. All other SCT scores will be classified as "pass".
15. Binomial SCT classification derived from each interval SCT scores compared to ACGME milestones. [ Time Frame: year 3 ]
    A "fail" classification is defined as an SCT score 1 SD below the respective PGY mean. All other SCT scores will be classified as "pass".
16. Binomial SCT classification derived from each interval SCT scores compared to family medicine rotation grades. [ Time Frame: year 1 ]
    A "fail" classification is defined as an SCT score 1 SD below the respective PGY mean. All other SCT scores will be classified as "pass".
17. Binomial SCT classification derived from each interval SCT scores compared to family medicine rotation grades. [ Time Frame: year 2 ]
    A "fail" classification is defined as an SCT score 1 SD below the respective PGY mean. All other SCT scores will be classified as "pass".
18. Binomial SCT classification derived from each interval SCT scores compared to family medicine rotation grades. [ Time Frame: year 3 ]
    A "fail" classification is defined as an SCT score 1 SD below the respective PGY mean. All other SCT scores will be classified as "pass".
19. Binomial SCT classification derived from each interval SCT scores compared to ITE [ Time Frame: year 1 ]
    A "fail" classification is defined as an SCT score 1 SD below the respective PGY mean. All other SCT scores will be classified as "pass".
20. Binomial SCT classification derived from each interval SCT scores compared to ITE [ Time Frame: year 2 ]
    A "fail" classification is defined as an SCT score 1 SD below the respective PGY mean. All other SCT scores will be classified as "pass".
21. Binomial SCT classification derived from each interval SCT scores compared to ITE [ Time Frame: year 3 ]
    A "fail" classification is defined as an SCT score 1 SD below the respective PGY mean. All other SCT scores will be classified as "pass".
22. Binomial SCT classification derived from each interval SCT scores compared to ABFM [ Time Frame: year 1 ]
    A "fail" classification is defined as an SCT score 1 SD below the respective PGY mean. All other SCT scores will be classified as "pass".
23. Binomial SCT classification derived from each interval SCT scores compared to ABFM [ Time Frame: year 2 ]
    A "fail" classification is defined as an SCT score 1 SD below the respective PGY mean. All other SCT scores will be classified as "pass".
24. Binomial SCT classification derived from each interval SCT scores compared to ABFM [ Time Frame: year 3 ]
    A "fail" classification is defined as an SCT score 1 SD below the respective PGY mean. All other SCT scores will be classified as "pass".

Eligibility Criteria

• Ages Eligible for Study: Child, Adult, Older Adult
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No
• Sampling Method: Non-Probability Sample

Study Population

Family medicine residents at 99MDG

Criteria

**Patients must be able to get care at Nellis Air Force Base (a military installation) in order to participate in this study**

Inclusion Criteria:

--Family Medicine resident at 99MDG

Exclusion Criteria:

-- N/A

Contacts and Locations

Contacts

Contact: Jill M Clark, MBA; 7026533298; Jill.M.Clark15.ctr@mail.mil

Locations

United States, Nevada

Mike O'Callaghan Military Medical Center; Recruiting

Las Vegas, Nevada, United States, 89191

Contact: Jill M Clark, MBA/HCM 702-653-3298 jill.m.clark15.ctr@mail.mil

Sponsors and Collaborators

Pamela Hughes

Investigators

• Study Director: Paul F Crawford, MD; US Air Force

  Study Documents (Full-Text)

Documents provided by Pamela Hughes, Mike O'Callaghan Military Hospital:

Study Protocol and Statistical Analysis Plan  [PDF] April 4, 2018

Informed Consent Form  [PDF] February 2, 2018

More Information

Additional Information:

about SCT 

Publications:

Gagnon R, Charlin B, Coletti M, Sauvé 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 Mar;39(3):284-91.

Fournier JP, Demeester A, Charlin B. Script concordance tests: guidelines for construction. BMC Med Inform Decis Mak. 2008 May 6;8:18. doi: 10.1186/1472-6947-8-18.

O'Neill TR, Li Z, Peabody MR, Lybarger M, Royal K, Puffer JC. The Predictive Validity of the ABFM's In-Training Examination. Fam Med. 2015 May;47(5):349-56.

• Responsible Party: Pamela Hughes, Principal Investigator, Mike O'Callaghan Military Hospital
• ClinicalTrials.gov Identifier: NCT03938610
• Other Study ID Numbers: FWH20190010H
• First Posted: May 6, 2019
• Last Update Posted: July 23, 2020
• Last Verified: July 2020

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No
• Plan Description: We do not plan on sharing data

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No