VALIDITY AND RELIABILITY OF AN OSCE FOR CLINICAL REASONING IN PHYSIOTHERAPY

Öz

Giriş. Bir değerlendirme aracı olan Hedef Yapılandırılmış Klinik Muayene (AGİT), klinik muhakeme ile ilgili becerilerin ölçülmesini garanti etmek için bir doğrulama süreci gerektirir. AGİT, mesleki uygulama oluşturma sürecinde karar verme süreciyle ilgilidir. Amaç. Klinik akıl yürütme için bir fizyoterapi lisans programı sırasında bir AGİT'in içerik geçerliliğini ve değerlendiriciler arası güvenilirliğini belirlemek. Malzemeler ve yöntemler. İçerik geçerliliğini iç tutarlılık (Cronbach's alpha) yoluyla tanımlayan araçsal tasarım, değerlendiriciler arası güvenilirliğin (sınıf içi korelasyon katsayısı) tanınmasına katkıda bulundu. Sonuçlar. Enstrüman, iyi bir iç tutarlılık ve esaslıdan neredeyse mükemmele doğru bir düzeyde uyum gösterir. Sonuçlar. AGİT, fizyoterapi öğrencilerinde klinik akıl yürütme becerilerini değerlendirmek için uygun bir araç olduğunu kanıtladı; bununla birlikte, bu doğrulama sürecinin istasyon sayısında ve fizyoterapiye yeterli uygulamanın olmamasıyla ilgili sınırlamaları vardır.

Anahtar Kelimeler

• Clinical skill
• Educational assessment
• Health education
• Physiotherapy
• Validity of tests

VALIDITY AND RELIABILITY OF AN OSCE FOR CLINICAL REASONING IN PHYSIOTHERAPY

Öz

Introduction. The Objective Structured Clinical Examination (OSCE), an evaluation instrument, requires a validation process to guarantee the measurement of skills related to clinical reasoning. The OSCE is relevant for decision making during the formation process for professional practice. Objective. To determine the content validity and inter-rater reliability of an OSCE during a physiotherapy undergraduate programme for clinical reasoning. Materials and Methods. Instrumental design, which identified content validity through internal consistency (Cronbach’s alpha), added to recognition of the inter-rater reliability (intraclass correlation coefficient). Results. The instrument demonstrates good internal consistency and a degree of agreement from substantial to almost perfect. Conclusions. The OSCE proved a suitable instrument to assess the clinical reasoning skill in physiotherapy students; nevertheless, this validation process has limitations in the number of stations and in not having sufficient application to physiotherapy.

Anahtar Kelimeler

• Clinical skill

Kaynakça

1. REFERENCES 1. Manzano AO, Lorena C, Solís B. El Examen Clínico Objetivo Estructurado como una herramienta para la evaluación formativa y de egreso en la Licenciatura en Rehabilitación - UADY. Iberoam para la iInvestigación y el Desarro Educ. 2013;10.
2. 2. Acosta Otalora ML, Villarraga Nieto Á del P, Castellanos Garrido AL, Alfonso Mora ML, Cobo Mejía EA, Sandoval Cuellar C, et al. La simulación clínica como estrategia de aprendizaje en fisioterapia. In: Coruniamericana, editor. Investigación en pedagogía y educación. Primera ed. Medellín: Coruniamericana; 2020. p. 177–92.
3. 3. Ginsburg LR, Tregunno D, Norton PG, Smee S, De Vries I, Sebok SS, et al. Development and testing of an objective structured clinical exam (OSCE) to assess socio-cultural dimensions of patient safety competency. BMJ Qual Saf. 2015;24(3):188–94.
4. 4. Ministerio de Salud y Proteccion Social. Perfil Profesional y competencias del Fisioterapeuta en Colombia [Internet]. 2015. Available from: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/TH/Perfil-profesional-competencias-Fisioterapeuta-Colombia.pdf
5. 5. Chávez Gil M, Barrantes Cabrera M. Confiabilidad y validez de las listas de cotejos del Examen Clínico Objetivo Estructurado para el aprendizaje por competencias de Cirugía. Rev Cienc Y Tecnol. 2014;10(3):115–28.
6. 6. Akhigbe T. Medical summative Objective Structured Clinical Examination assessment : A mini review. Int J Med Rev. 2018;5(4):140–2.
7. 7. Hastie MJ, Spellman JL, Pagano PP, Hastie J, Egan BJ. Designing and implementing the objective structured clinical examination in anesthesiology. Anesthesiology. 2014;120(1):196–203.
8. 8. Acosta ótalora ML, Alfonso Mora ML, Castellanos Garrido AL, Castellanos Vega R del P, Cobo Mejía EA, Goyeneche Ortegón RL, et al. Simulación clínica. Una experiencia en fisioterapia. Sabana U de La, editor. Chía: Universidad de La Sabana; 2020. 1–143 p.

9. 9. American Physical Therapy Association. Guide to Physical Therapist Practice 3.0. American Physical Therapy Association; 2014.
10. 10. Durante Montiel, Lozano Sánchez, Martínez González, Morales López SM. Evaluación de competencias en ciencias de la salud. México: Editorial medica panamericana; 2012. 152 p.
11. 11. Ato M, López-García JJ, Benavente A. A classification system for research designs in psychology. Ann Psychol. 2013;29(3):1038–59.
12. 12. Ramada-Rodilla JM, Serra-Pujadas C, Delclós-Clanchet GL. Adaptación cultural y validación de cuestionarios de salud: Revisión y recomendaciones metodológicas. Salud Publica Mex. 2013;55(1):57–66.
13. 13. Dios J De, Núñez M, Iniesta AA. Coeficiente alfa de Cronbach para medir la fiabilidad de un cuestionario difuso. CULCyT. 2016;13(59):146–57.
14. 14. Cortés-Reyes É, Rubio-Romero JA, Gaitán-Duarte H. Métodos Estadísticos De Evaluación De La Concordancia Y La Reproducibilidad De Pruebas Diagnósticas. Rev Colomb Obstet Ginecol [Internet]. 2010;61(3):247–55. Available from: 10.1074/jbc.M112.438416
15. 15. Hernández Gutiérrez LS, Trejo JA, Marín Campos Y. Diseño de un ECOE para evaluar habilidades clínicas en neurología en estudiantes del quinto año. Investig en Educ Médica [Internet]. 2017;6(24):248–54. Available from: http://linkinghub.elsevier.com/retrieve/pii/S2007505717300029
16. 16. Wessel J, Williams R, Finch E GM. Reliability and validity of an objective structured clinical examination for physical therapy students. J Allied Heal [Internet]. 2003;32(4):266–9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/14714601
17. 17. Trejo Mejía JA, Martínez González A, Méndez Ramírez I, Morales López S, Ruiz Pérez L, Mendiola MS. Evaluación de la competencia clínica con el examen clínico objetivo estructurado en el internado médico de la Universidad Nacional Autónoma de México. Gac Med Mex. 2014;150:8–17.
18. 18. Bujack L, McMillan M, Dwyer J, Coordinator C, Hazeton M. Assessing comprehensive nursing performance: the Objective Structural Clinical Assessment (OSCA) Part 1 - Development of the assessment strategy. Nurse Educ Today. 1991;11(3):179–84.
19. 19. Margareth Lorena Alfonso-Mora, Adriana Lucía Castellanos-Garrido, Angélica del Pilar Villarraga Nieto, Martha Lucía Acosta-Otálora, Carolina Sandoval-Cuellar, Rocío del Pilar Castellanos-Vega, Ruth Liliana Goyeneche-Ortegón EAC-M. Aprendizaje basado en simulación: estrategia pedagógica en fisioterapia. Revisión integrativa. Educ Médica [Internet]. 2020;21(6):357–63. Available from: https://doi.org/10.1016/j.edumed.2018.11.001
20. 20. Ward H, Willis A. Assessing advanced clinical practice skills. Prim Heal Care [Internet]. 2006;16(3):22–4. Available from: http://libproxy1.nus.edu.sg/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=106456705&site=ehost-live
21. 21. Harden R, Gleeson FA. Assessment of clinical competence using an objective structured clinical examination (0s CE). Med Educ. 1979;13:41–54.