Analysis of a Resident Competence Self-Assessment Survey

Abstract

ABSTRACT Introduction Orthotic and prosthetic clinicians need to self-assess their performance and make decisions about practice limitations and continuing education throughout their careers. The objectives of this study were to evaluate the internal consistency of a self-assessment survey, examine the latent common factors and responsiveness of the survey, and use the results of the analysis to develop a shortened self-assessment survey. Methods Residents completed a self-assessment 29-item survey based on the six domains of the American Board for Certification in Orthotics, Prosthetics, and Pedorthics (ABC) Practice Analysis of Certified Practitioners in the Disciplines of Orthotics and Prosthetics at multiple times during the clinical residency. Internal consistency was examined through Cronbach α. Confirmatory and exploratory factor analysis were used to examine latent common factors and inform item reduction. Responsiveness was examined through repeated-measures analysis of variance (ANOVA). Results Analysis revealed a Cronbach α of 0.927. Confirmatory factor analysis indicated a poor fit of the six-factor model. The final and best-fitting model suggested four latent common factors: patient centeredness, regulatory awareness, device evaluation, and professional responsibility. Review and revision of the items resulted in a 14-item instrument. The instrument was responsive to changes over time. Conclusions The results indicate a need to reexamine current clinical practice framework in orthotics and prosthetics, particularly as it relates to clinical competence. Future research should evaluate the performance of the shortened self-assessment survey and consider implications for educational standards. Clinical Relevance The use of validated educational tools can strengthen the efficacy of assessments in clinical education and residency. Improved clinical education assessments may result in standardization of competency and improved graduate preparedness.