Development of a Tool to Measure Clinical Competence in Occupational Therapy: A Pilot Study?

Abstract

Clinical competence is generally defined as a combination of knowledge, skill and professional behaviour. It is typically assessed using written tests, direct observation, chart audit, client satisfaction surveys and supervisor ratings. This paper describes the development and evaluation of a chart-stimulated recall (CSR) measure that combines the methods of chart audit and clinician interview to assess the clinical competence of practicing occupational therapists. The CSR tool was developed using the Canadian Guidelines for Client-Centred Practice and taps global domains of competence: use of theory, assessment, program planning, intervention, discharge planning, follow-up, program evaluation, clinical reasoning and professional behaviours. This pilot study involved two independent raters/interviewers who assessed twelve occupational therapy clinicians on two occasions using a random sample of client cases/records on each occasion Results indicate that the CSR tool is not only reliable and valid, but also sufficiently generic to be used in a variety of practice settings as a global measure of on-the-job performance.

Body weight-supported treadmill training in chronic incomplete spinal cord injury: a pilot study evaluating functional health status and quality of life

“…18 Activities 1. Self-rated: perceived problematic skills (Canadian Occupational Performance Measure (COPM)), [19][20][21] and a semistructured interview of subjects and their partners (TE). 2.…”

“…The possibility to perform these skills (0 ¼ major problems; 10 ¼ superior) and satisfaction with performance (0 ¼ major regrets; 10 ¼ extremely satisfied) were scored. 20 The performance and satisfaction scores were the average of the scores for the five skills. The reliability and validity of the instrument have been demonstrated in several disease populations.…”

Using patients’ charts to assess medical trainees in the workplace: A systematic review

“…Further, all of the assessors and 87% of the assessed physicians agreed that CBD was a useful quality improvement tool for revalidation. Salvatori et al (2000) reported a high correlation between supervisors' ratings and the CSR's interviewers' global ratings of overall competence of practicing occupational therapists denoting concurrent validity. The evidence supporting the use of CBD or CSR for the assessment of medical trainees emanated from subjective reports on their educational impact.…”

The Feasibility and Acceptability of Using a Portfolio to Assess Professional Competence

“…16,20 For example, the CPO's Practice Assessment also employs a chart-stimulated recall process. 40,41 Some study participants raised concerns about the accuracy of the materials included in the portfolio, noting that these can be susceptible to bias or inaccuracies. It has been suggested that cultural factors may influence both the way one presents oneself within portfolio records and the ease with which one keeps records.…”