Script Concordance Testing in Genetic Counseling Training: A Pilot Study

Clinical decision-making has been successfully measured by script concordance testing in various healthcare training programs; it has never been used in genetic counseling education. The aim of this pilot study was to assess script concordance testing in the field of genetic counseling as an objective measure of clinical reasoning in trainees. The script concordance test was administered to 22 second year genetic counseling students in the Joan H. Marks Graduate Program in Human Genetics at Sarah Lawrence College. 12 genetic counselors served on a panel to provide expert judgment responses, and a scoring grid was developed using the Aggregate Scores Method. The utility of the tool was measured using Cronbach’s alpha coefficient, and scores of students and the panel were compared using Hedge’s g. Results revealed statistically significant differences between the scores of panelists and students and good reliability. Concordance and discordance in clinical reasoning was compared across case categories where anchored cases demonstrated the highest overall degree of discordance and ethics cases demonstrated the highest overall degree of concordance. Script concordance testing can be used to measure clinical decision-making skills in genetic counseling trainees in a way that is reliable, standardized, and easy to use