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

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.