THE DEVELOPMENT AND VALIDATION OF THE SEATING AND MOBILITY SCRIPT CONCORDANCE TEST (SMSCT)

[摘要] Although participation in continuing education activities is the most widely accepted method of upgrading professional training in the area of seating and mobility, the impact of these educational experiences has yet to be documented. Specifically, reliable and valid measures of the outcomes of educational experiences or clinical practice on the ability to make specialized clinical decisions are needed. This dissertation is comprised of a series of three, inter-related studies, which, develop and validate the Seating and Mobility Script Concordance Test (SMSCT); a performance-based measure intended for use with professionals that recommend seating and mobility devices to individuals with spinal cord injuries. The SMSCT is designed to assess clinicians by examining the organization of their knowledge, associations between items of their knowledge, and adequacy of their clinical decisions compared to expert consensus. The first study presents the conceptual foundation, item generation process, and content validity evidence leading to the final version of the SMSCT. Results indicate that the 67-item SMSCT adequately represents the dimensions of assessment and intervention knowledge for seating and mobility for spinal cord injury. In the second study, 15 spinal cord injury experts assisted with the development of the scoring system, and 100 physical and occupational therapists were used for obtaining internal and external validity evidence. Appraisal of the technical quality of the test showed reasonable item performance, with some items performing better than others. Other evidence showed the SMSCT distinguished between intervention subscores for two groups of known differences. Proxy measures of clinical expertise on the whole did not prove to be strong predictors of SMSCT scores for a population of clinicians with varying amounts of seating and mobility experience. The third study, comprised of 50 seating and mobility clinicians, further explored the validity of the SMSCT as a measure of educational effectiveness. No one proxy measure of clinical expertise accounted for a considerable change in posttest scores following an educational program. Changes in SMSCT scores were detected following an educational program. Initial psychometric testing maintains that the SMSCT is a promising measure of seating and mobility clinical expertise. Further SMSCT development, revision and validation are needed.

[发布机构] the University of Pittsburgh

[效力级别] educational measurement