Rehabilitation, Academic Medical Center Amsterdam, 1100 DD Amsterdam, The Netherlands.
J Rehabil Med. 2019 Jun 18;51(6):418-425. doi: 10.2340/16501977-2562.
To evaluate the validity of a script concordance test to assess guideline-consistent clinical reasoning by physical therapists in stroke rehabilitation, and to identify critical features of physical therapists specializing in stroke rehabilitation.
A script concordance test was developed according to current standards. Four subgroups of physical therapists (those specializing in neurology, those focusing on neurology or geriatrics, other, and non-specialized undergraduate students) were asked to complete the test. The construct validity of the script concordance test was evaluated with 1-way analysis of variance (ANOVA) to estimate differences between subgroups. Associations between physical therapist characteristics, and script concordance test scores were analysed with bivariate regression analysis followed by multivariate analyses.
The script concordance test, with 59 items, was completed by 211 physical therapists. ANOVA analysis showed statistically significant differences between the script concordance test scores of the 4 groups (p<0.001), with higher scores by the physical therapists specializing in neurology compared with the other, non-specialized, subgroups. The multivariate analysis showed that better guideline knowledge (B = 1.07; CI = 0.48-1.65; p =<0.001), successful completion of the Dutch Neurorehabilitation course (B = 4.1; CI = 1.37-6.87; p = 0.003), and participation in professional development activities (B = 2.4; CI = 0.05-4.68; p = 0.046) were associated with higher script concordance test scores.
The script concordance test has good construct validity. Greater self-reported guideline knowledge, successful completion of the post-bachelor Dutch Neurorehabilitation course, as well as systematic participation in professional development activities facilitate important factors that enhance specialization. The script concordance test is a valid feedback tool for physical therapists to support professional development in the domain of stroke rehabilitation.
评估脚本一致性测试在评估物理治疗师在中风康复中遵循指南的临床推理能力的有效性，并确定专门从事中风康复的物理治疗师的关键特征。
根据现行标准制定脚本一致性测试。要求四个物理治疗师亚组（神经科专业、神经科或老年病学专业、其他专业和非专业本科学生）完成测试。使用单因素方差分析（ANOVA）评估脚本一致性测试的结构有效性，以估计亚组之间的差异。使用双变量回归分析和多变量分析分析物理治疗师特征与脚本一致性测试得分之间的关联。
211 名物理治疗师完成了包含 59 个项目的脚本一致性测试。ANOVA 分析显示，4 个亚组的脚本一致性测试得分存在统计学差异（p<0.001），神经科专业的物理治疗师得分高于其他、非专业的亚组。多变量分析显示，更好的指南知识（B=1.07；CI=0.48-1.65；p<0.001）、成功完成荷兰神经康复课程（B=4.1；CI=1.37-6.87；p=0.003）和参与专业发展活动（B=2.4；CI=0.05-4.68；p=0.046）与更高的脚本一致性测试得分相关。
脚本一致性测试具有良好的结构有效性。更高的自我报告指南知识、成功完成本科后荷兰神经康复课程以及系统参与专业发展活动是增强专业化的重要因素。脚本一致性测试是一种有效的反馈工具，可支持物理治疗师在中风康复领域的专业发展。
