Assessment of intraoperative judgment during gynecologic surgery using the Script Concordance Test

Am J Obstet Gynecol. 2010 Sep;203(3):240.e1-6. doi: 10.1016/j.ajog.2010.04.010. Epub 2010 May 21.


Objective: We sought to develop a valid, reliable assessment of intraoperative judgment by residents during gynecologic surgery based on Script Concordance Theory.

Study design: This was a multicenter prospective study involving 5 obstetrics and gynecology residency programs. Surgeons from each site generated case scenarios based on common gynecologic procedures. Construct validity was evaluated by correlating scores to training level, in-service examinations, and surgical skill and experience using a Global Rating Scale of Operative Performance and case volumes.

Results: A final test that included 42 case scenarios was administered to 75 residents. Internal consistency (Cronbach alpha = 0.73) and test-retest reliability (Lin correlation coefficient = 0.76) were good. There were significant differences between test scores and training levels (P = .002) and test scores correlated with in-service examination scores (r = 0.38; P = .001). There was no association between test scores and total number of cases or technical skills.

Conclusion: The Script Concordance Test appears to be a reliable, valid assessment tool for intraoperative decision-making during gynecologic surgery.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Canada
  • Clinical Competence*
  • Decision Making*
  • Educational Measurement*
  • Gynecologic Surgical Procedures / education*
  • Gynecology / education
  • Humans
  • Internship and Residency
  • Intraoperative Period
  • Judgment*
  • Obstetrics / education
  • Prospective Studies
  • Reproducibility of Results
  • United States