The Development of an Assessment Tool to Measure the Clinical Performance of Orthopedic Residents

Abstract

Introduction. Residency programs have been developed to provide formal instruction and mentorship after professional education to accelerate the development of the physical therapists' knowledge, skills, and clinical decision making for patient management. An assessment tool that could be used during the assessment and treatment of patients would provide valuable information regarding the progression of the multiple skills required for a high level of clinical practice throughout residency education. The purpose of this study was to develop a reliable and valid tool to assess the multiple clinical skills used in the examination, evaluation, and treatment of patients with common musculoskeletal conditions. Methods. To meet the purpose, a sequential interrater reliability and known-groups validity study was performed. The original clinical performance assessment tool was developed using the practice dimensions outlined by the Orthopaedic Physical Therapy Description of Specialty Practice. The tool underwent 3 rounds of reliability testing. In addition, known-groups validity was established using residency graduates and experienced matched controls. Results. The overall reliability of the 64-item assessment tool was found to be high. Fifty-four of the items on the examination had high to perfect reliability and 10 items demonstrated moderate reliability. Furthermore, the tool was accurate in determining physical therapists with residency training versus experienced matched controls, establishing known-groups validity. Discussion and Conclusion. The assessment tool was able to evaluate clinical performance during patient care activities in both residency trained physical therapists and therapists without advanced instruction with a moderate to high interrater reliability on all items.