Script questionnaires: their use for assessment of diagnostic knowledge in radiology

The Diagnostic Script Questionnaire (DSQ) is innovative in its format and its scoring process. It stems from the hypothetico-deductive reasoning and the illness script theories. In this exploratory study arguments favouring a progressive construction of illness scripts along with clinical experience were sought and the possible use of the script concept was tested to assess clinical competence. The research was conducted in radiology. The investigation used the radiological hyperlucent unilateral hemithorax syndrome as diagnostic challenge. The questionnaire was answered by three groups of participants: nine seasoned radiologists (with at least three years of experience), seven radiology residents (from year 1 to year 5), and 14 clerkship students who completed the questionnaire at the end of their radiology rotation. The data support the hypothesis of a progressive construction of specialized memory structures from students to seasoned radiologists. The DSQ was able to discriminate among participants according to their expected level of diagnostic clinical competence.