Background/Purpose: A validated script concordance assessment (SCT) for gout was created for use in the internal medicine residency program at the University of Maryland Medical Center (UMMC). The assessment demonstrated high reliability and large effect size in a population of 143 learners.¹ The aim of this pilot study was to explore the feasibility of using this tool with interprofessional, multilevel groups of learners at the Center of Excellence in MSK Care and Education (MSK COE) at the Salt Lake City Veterans Affairs Medical Center (SLC VAMC), to inform full implementation of the SCT in July, 2017.

Methods: A convenience sample of 19 learners (14 students or trainees; 5 practicing primary care providers (PCPs)) participating in programs at the SLC VAMC MSK COE, were asked to complete the SCT before and after a didactic session on gout. They were then sent emails containing the URL to access the SCT before and after the didactic. Time to complete the survey was not provided during the course. SCT was scored using an aggregate scoring method based on the results of an expert panel. Average pre- and post-test scores were calculated. A one-way ANOVA was used to compare pre- and post-test scores.

Results: Nine learners (47%) completed both the pre- and post-didactic SCT. The maximum possible SCT score was 50.16 points. For reference, the average score of the expert panel was 40.65 (SD=1.72) points. The average pre- and post-test scores for the UMMC population were 31.32 (SD=3.12) points and 33.98 (SD=2.72) points, respectively. The average pre-test score for the SLC VAMC population was 29.71 (SD=5.08) points. The average post-test score was 32.04 (SD=2.73) points. SLC VAMC learners did not show a statistically significant increase in scores after didactics, p=0.243. Individual learner demographics, pre-test scores, and post-test scores are below.

Conclusion: This pilot study demonstrates feasibility of implementing a validated SCT to assess knowledge of gout in a different institution, across an interprofessional and multilevel group of learners. The response rate was low, indicating that different methods of interfacing with this instrument, including confirmation of participation, are needed with our learner groups. The larger pre-course variance, relative to the reference population, may reflect the comparative diversity of our learners, but the small sample size and response rate limit the validity of statistical inferences. We will continue to use the SCT assessment in the MSK Education Week curriculum and accrue additional learners in order to better understand its use as an assessment.

Reference: 1. Siaton BC, Clayton E, Kueider AM, Rietschel M. Use of Script Concordance Testing to Evaluate the Efficacy of a Web-Based Module on Gout: Three Years of Experience [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10).

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-pilot-study-of-the-use-of-a-validated-gout-script-concordance-test-assessment-in-an-interdisciplinary-musculoskeletal-education-program/