运用脚本一致性测验评价第一年物理治疗专业学生的临床推理能力。

Evaluating clinical reasoning in first year DPT students using a script concordance test.

机构信息

University of Indianapolis, 1400 E. Hanna Ave, 46227, Indianapolis, IN, USA.

出版信息

BMC Med Educ. 2024 Mar 22;24(1):329. doi: 10.1186/s12909-024-05281-w.

DOI:10.1186/s12909-024-05281-w

PMID:38519915

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11404025/

Abstract

BACKGROUND

A script concordance test (SCT) provides a series of clinical vignettes to assess clinical reasoning in uncertainty. Appraised throughout health education literature, SCTs are cognitive assessments of clinical reasoning, though their use in Doctor of Physical Therapy (DPT) entry-level education has not been investigated. The purpose of this study was to develop and explore the reliability and validity of a SCT for first year DPT students.

METHODS

The SCT was developed and implemented over four phases. During phases one and two, DPT program faculty consulted on course content from the first-year curriculum. Thirty clinical vignettes with three follow-up questions each were constructed. The SCT was pilot tested with five clinicians in phase three to assess question clarity. During phase four, the SCT was administered to students and a reference panel via Qualtrics. First year DPT students (n = 44) and reference panel physical therapists with at least two years of experience and advanced certification (n = 15) completed the SCT. Internal consistency was analyzed using Cronbach's Alpha. Differences between student and reference panel percent-correct scores were analyzed with a t-test. Relationships between student SCT scores and academic records were explored with Spearman's Rho.

RESULTS

The SCT had an internal consistency of 0.74. A significant difference in scores was found between the students [mean 58.5 (+/-5.31)] and reference panel [65.8 (+/-4.88), p < .01]. No significant correlations between student SCT scores and academic records were found.

CONCLUSIONS

The developed SCT was reliable and demonstrated satisfactory internal consistency among test items. The SCT successfully differentiated between groups, with the reference panel demonstrating statistically significant higher percent-correct scores compared to students. SCTs may provide means to measure clinical reasoning in DPT students and lead to novel pedagogical approaches to enhance clinical reasoning.

摘要

背景

脚本一致性测试（SCT）提供了一系列临床病例，以评估不确定性下的临床推理能力。SCT 在整个健康教育文献中都得到了评估，是对临床推理的认知评估，但在物理治疗博士（DPT）入门教育中的应用尚未得到研究。本研究的目的是开发和探索适用于一年级 DPT 学生的 SCT 的可靠性和有效性。

方法

SCT 经过四个阶段开发和实施。在第一和第二阶段，DPT 项目教师就第一年课程的课程内容进行了咨询。共构建了 30 个具有三个后续问题的临床病例。在第三阶段，SCT 由五名临床医生进行了试点测试，以评估问题的清晰度。在第四阶段，通过 Qualtrics 将 SCT 提供给学生和参考小组。一年级 DPT 学生（n=44）和至少具有两年经验和高级认证的参考小组物理治疗师（n=15）完成了 SCT。使用 Cronbach 的 Alpha 分析内部一致性。使用学生和参考小组的正确百分比分数之间的 t 检验分析差异。使用 Spearman's Rho 探索学生 SCT 分数与学术记录之间的关系。