Enhancing Rigour in Orthopaedic Manual Physical Therapy Certification: Development of an Assessment Rubric for a Test of Clinical Reasoning
Year: 2015
Type: dissertation
Abstract: Background: Assessment of competence is an important part of post-graduate certification in the health professions. These assessments result in judgments about how candidates would perform in real practice; thus, certification processes can have wide reaching implications for the candidate, the certifying institutions, and the public. In the field of Orthopaedic manual physical therapy (OMPT), post-graduate certification entails the assessment of a range of competencies including clinical reasoning. OMPT is an internationally recognized subspecialty within physiotherapy, and certification in this domain occurs worldwide. Yet, there is currently little documented evidence supporting OMPT certification processes. This is an issue because the validity of these processes may be questionable and vulnerable to scrutiny. Purpose: To address this research gap, this dissertation aimed to enhance the rigour of OMPT certification by developing and testing a new assessment rubric to standardize the appraisal of written responses to a short-answer test of clinical reasoning. Methods: To accomplish this aim, a modified Delphi method was used to determine the clinical reasoning assessment criteria important for OMPT certification. An assessment rubric called the Case History Assessment Tool (CHAT) was then constructed based on these assessment criteria for the Canadian short-answer test of clinical reasoning. Using validity theory as a framework, a second and third study was conducted to generate validity evidence for the content, response process and internal structure associated with the CHAT. Results: This dissertation yielded 53 assessment criteria which were strongly endorsed by an international panel of OMPT experts. These criteria were subsequently applied to develop a standardized assessment rubric for the Canadian short-answer test of clinical reasoning. Validity evidence was generated from three different sources that support the content, response process and internal structure of the CHAT. Conclusions: The assessment criteria identified through this dissertation will be relevant to other OMPT training programs insofar as institution-specific testing occurs prior to their use. Validity evidence was generated to support the scores derived from the CHAT within the Canadian OMPT certification context. Further validity evidence is needed from other sources of validity within this context. Finally, the contextual factors of clinical reasoning will need to be considered in the development and assessment of clinical reasoning in post-graduate certification.
Source: TSpace (University of Toronto)
Author: Euson Yeung
Language: English
Subfield: Family Practice
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2623468994