Validating a Standardized Patient Assessment Tool Using Published Professional Standards

Background and Purpose. Standardized patient (SP) encounters are used to teach and assess various professional skills. Although well established in medical education, the validity of assessing student performance during SP encounters has not been adequately addressed in physical therapist education. This paper presents a method for validating an SP assessment tool for use in a high‐stakes exam within a Doctor of Physical Therapy program using published professional standards. Method Description and Evaluation. Faculty in a physical therapist education program developed an assessment tool for the first of 4 SP encounters students must pass to progress in the curriculum. Criteria were matched to specific statements in the Guide to Physical Therapist Practice, A Normative Model of Physical Therapist Professional Education, and Minimum Required Skills of Physical Therapists Graduates at Entry‐Level. A survey was developed listing each assessment criteria with its corresponding statements from the 3 professional documents. Respondents' levels of agreement were assessed using a 4‐point Likert scale. The chi‐square (X2) goodness of fit was used to determine the level of agreement between the assessment criteria and the practice expectation statements. Additional comments were analyzed using qualitative methods. Outcomes. Thirty academic and clinical educators completed the survey. Ninetysix percent (22/23) of the SP assessment criteria reached statistically significant levels of agreement, with matching statements from at least one of the professional documents. Respondents indicated that the SP assessment tool was either more detailed or specific than the published professional documents; however, it was generally less comprehensive. Discussion. Faculty concluded that the SP assessment criteria were generally consistent with practice expectations and thus a valid form of measurement. Differences can be attributed to the purposes of professional publications and the specific SP encounter. Conclusion. SP encounters can help to ensure the safety of aspiring clinicians prior to clinical practice. The method presented uses published professional expectations to validate a high‐stake assessment of student clinical competence during SP encounters. Using published professional documents to validate classroom assessment tools has the added benefit of connecting classroom teaching and assessment to practice.

[1]  R. Harden,et al.  Assessment of clinical competence using an objective structured clinical examination (OSCE). , 1979, Medical education.

[2]  L. Kloth,et al.  Supervised versus independent student laboratories. , 1983, Physical therapy.

[3]  H. Barrows,et al.  A comprehensive performance-based assessment of fourth-year students' clinical skills. , 1987, Journal of medical education.

[4]  J. Balogun Predictors of academic and clinical performance in a baccalaureate physical therapy program. , 1988, Physical therapy.

[5]  D. Swanson,et al.  Use of Standardized Patients for Teaching And Assessing Clinical Skills , 1990 .

[6]  Robyn Tamblyn,et al.  Sources of unreliability and bias in standardized‐patient rating , 1991 .

[7]  D. Witzke,et al.  Predictive validity of a required multidisciplinary standardized‐patient examination , 1992, Academic medicine : journal of the Association of American Medical Colleges.

[8]  Proceedings of the AAMC'S Consensus Conference on the Use of Standardized Patients in the Teaching and Evaluation of Clinical Skills. Washington, D.C., December 3-4, 1992. , 1993, Academic medicine : journal of the Association of American Medical Colleges.

[9]  Robyn Tamblyn,et al.  Can standardized patients predict real‐patient satisfaction with the doctor‐patient relationship? , 1994 .

[10]  F. Degruy,et al.  Stability of standardized patients' performance in a study of clinical decision making. , 1995, Family medicine.

[11]  B. Ferrell A Critical Elements Approach to Developing Checklists for a Clinical Performance Examination , 1996 .

[12]  J. Colliver,et al.  Validity of standardized‐patient examination scores as an indicator of faculty observer ratings , 1996, Academic medicine : journal of the Association of American Medical Colleges.

[13]  L. Perritt,et al.  A Descriptive Study Comparing Achievement of Clinical Education Objectives and Clinical Performance Between Students Participating in Traditional and Mock Clinics , 1996 .

[14]  P Wallace,et al.  Following the threads of an innovation: the history of standardized patients in medical education. , 1997, Caduceus.

[15]  R. Ladyshewsky,et al.  Communication skill development in health professional education: the use of standardised patients in combination with a peer assessment strategy. , 1997, Journal of allied health.

[16]  Standards of practice for physical therapy and the accompanying criteria. The American Physical Therapy Association. , 1997, Physical therapy.

[17]  J. Creswell Qualitative inquiry and research design: choosing among five traditions. , 1998 .

[18]  R. Reznick,et al.  Comparing the psychometric properties of checklists and global rating scales for assessing performance on an OSCE‐format examination , 1998, Academic medicine : journal of the Association of American Medical Colleges.

[19]  G. Regehr,et al.  OSCE checklists do not capture increasing levels of expertise. , 1999, Academic medicine : journal of the Association of American Medical Colleges.

[20]  Richard K. Ladyshewsky,et al.  Evaluating Clinical Performance in Physical Therapy With Simulated Patients , 2000 .

[21]  M. Rose,et al.  Widening the lens on standardized patient assessment: what the encounter can reveal about the development of clinical competence. , 2001, Academic medicine : journal of the Association of American Medical Colleges.

[22]  B. Black,et al.  Feasibility of Using Standardized Patients in a Physical Therapist Education Program: A Pilot Study , 2002 .

[23]  D. Klamen,et al.  Using Standardized Patients for Formative Feedback in an Introduction to Psychotherapy Course , 2002, Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry.

[24]  Elspeth Finch,et al.  Reliability and validity of an objective structured clinical examination for physical therapy students. , 2003, Journal of allied health.

[25]  K. Kaiser,et al.  Achieving clarity in evaluation of community/public health nurse generalist competencies through development of a clinical performance evaluation tool. , 2003, Public health nursing.

[26]  J. Martindale,et al.  The Efficacy of Standardized Patient Feedback in Clinical Teaching: A Mixed Methods Analysis , 2004, Medical education online.

[27]  A content validity of a clinical education performance tool: the physical therapist manual for the assessment of clinical skills. , 2005, Journal of allied health.

[28]  Gregory S. Ford,et al.  Effect of Computer‐Assisted Instruction Versus Traditional Modes of Instruction on Student Learning of Musculoskeletal Special Tests , 2005 .

[29]  L. Hale,et al.  Standardized Patients and Multidisciplinary Classroom Instruction for Physical Therapist Students to Improve Interviewing Skills and Attitudes About Diabetes , 2006 .

[30]  Karen J. Panzarella,et al.  A model for integrated assessment of clinical competence. , 2007, Journal of allied health.

[31]  Karen J. Panzarella,et al.  Using the Integrated Standardized Patient Examination to Assess Clinical Competence in Physical Therapist Students , 2008 .

[32]  C. Shawler Standardized patients: a creative teaching strategy for psychiatric-mental health nurse practitioner students. , 2008, The Journal of nursing education.

[33]  Who will pass the dental OSCE? Comparison of the Angoff and the borderline regression standard setting methods. , 2009, European journal of dental education : official journal of the Association for Dental Education in Europe.

[34]  Patricia K. Bradley,et al.  Evaluating the Use of Standardized Patients in Undergraduate Psychiatric Nursing Experiences , 2009 .

[35]  Thomas J. Smith,et al.  Nutrition‐Based Standardized Patient Sessions Increased Counseling Awareness and Confidence Among Dietetic Interns , 2009 .

[36]  S. Edmond,et al.  The Use of Standardized Patients in Physical Therapist Education Programs , 2009 .