Is a web-based concordance test feasible to assess therapeutic decision-making skills in a French context?

Abstract

Background: At the end of undergraduate medical curriculum, a written simulation-based examination is used in France to assess therapeutic decision-making skills and to rank students for the purpose of matching their training specialties. However, this examination based on a single assessment method remains a subject of debate.

Aim: To study the feasibility of a web-based Concordance test for therapeutic decision-making assessment.

Methods: A 12 clinical-case Concordance test was developed based on objectives for the undergraduate training program. The test was administered on line to candidates with different levels of clinical experience. Fifteen therapeutic teachers constituted the reference panel. Data analysis included analysis of variance, post-hoc test, and Cronbach's alpha.

Results: One hundred and seventy participants (113 students, 34 residents, 23 physicians) fully completed the free-access test on line with no technical problems. Differences between the mean scores for groups were significant (p < 0.001). Significant differences occurred between fourth year students and residents (p < 0.001), fourth year students and physicians (p = 0.001). No difference was found between residents and physicians. Reliability coefficient was 0.67.

Conclusion: A web-based Concordance test in the field of therapeutic decision-making was considered feasible in a French learning environment. Further research is warranted to determine its usefulness as a part of the National Examination.

Additional information

Notes on contributors

Louis Sibert

LOUIS SIBERT, MD, PhD, is an Associate Professor of Urology in the Department of Urology, Rouen University Hospital. He is also a member of the Department of Medical Education and a member of the CISMeF (catalog and index of French-speaking Medical sites) team, Rouen University Hospital, Rouen, France.

Roch Giorgi

ROCH GIORGI, MD, PhD, is an Associate Professor of Biostatistics at the Department of Public Health – Medical Informatics, Marseille University Hospital, and a member of LERTIM Lab, EA 3283, Aix-Marseille University, Faculty of Medicine, Marseille, France.

Badisse Dahamna

BADISSE DAHAMANA is a Research Engineer, member of the CISMeF team, Rouen University Hospital, France.

Jean Doucet

JEAN DOUCET, MD, PhD, is a Professor of Therapeutics and member of the Department of Medical Education, Rouen University Hospital, Rouen, France. He is also the responsible for the Therapeutics Teaching Program at the Rouen University Hospital Faculty of Medicine.

Bernard Charlin

BERNARD CHARLIN, MD, is a Professor of Surgery. He is also the Director of the Research and Development Unit in Medical Education, Faculty of Medicine, University of Montreal, Montreal, Canada.

Stefan J. Darmoni

STEFAN J. DARMONI, MD, PhD, is a Professor of Medical Informatics, Rouen University Hospital. He is also the Director of CISMeF, Rouen University Hospital, and a member of LITIS Lab, EA 4108, Rouen University, France.