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

Tracking Information

• First Submitted Date: May 1, 2019
• First Posted Date: May 6, 2019
• Last Update Posted Date: July 23, 2020
• Actual Study Start Date: June 1, 2019
• Estimated Primary Completion Date: June 2024 (Final data collection date for primary outcome measure)

Current Primary Outcome Measures (submitted: May 2, 2019)

• 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.
• 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.
• 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.
• 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.
• 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.
• 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.
• 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.
• 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.
• 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.
• 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.
• 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.
• 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.
• 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".
• 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".
• 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".
• 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".
• 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".
• 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".
• 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".
• 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".
• 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".
• 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".
• 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".
• 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".

• Original Primary Outcome Measures: Same as current
• Current Secondary Outcome Measures: Not Provided
• Original Secondary Outcome Measures: Not Provided
• Current Other Pre-specified Outcome Measures: Not Provided
• Original Other Pre-specified Outcome Measures: Not Provided

Descriptive Information

• Brief Title: Do Script Concordance Tests Correlate With Family Medicine Standardized Tests and Failing Rotation Grades?
• Official Title: Do Script Concordance Tests Correlate With Family Medicine Standardized Tests and Failing Rotation Grades?
• 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.

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 Type: Observational
• Study Design: Observational Model: Cohort; Time Perspective: Prospective
• Target Follow-Up Duration: Not Provided
• Biospecimen: Not Provided
• Sampling Method: Non-Probability Sample
• Study Population: Family medicine residents at 99MDG
• Condition: Knowledge, Attitudes, Practice
• Intervention: Not Provided
• Study Groups/Cohorts: Not Provided

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.

Recruitment Information

• Recruitment Status: Recruiting
• Estimated Enrollment (submitted: May 2, 2019): 130
• Original Estimated Enrollment: Same as current
• Estimated Study Completion Date: June 2024
• Estimated Primary Completion Date: June 2024 (Final data collection date for primary outcome measure)

Eligibility 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

Sex/Gender

• Sexes Eligible for Study: All

• Ages: Child, Adult, Older Adult
• Accepts Healthy Volunteers: No

Contacts

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

• Listed Location Countries: United States

Administrative Information

• NCT Number: NCT03938610
• Other Study ID Numbers: FWH20190010H
• Has Data Monitoring Committee: No

U.S. FDA-regulated Product

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

IPD Sharing Statement

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

• Responsible Party: Pamela Hughes, Mike O'Callaghan Military Hospital
• Study Sponsor: Pamela Hughes
• Collaborators: Not Provided

Investigators

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

• PRS Account: Mike O'Callaghan Military Hospital
• Verification Date: July 2020