Flew Brooke, Chipchase Lucy, Lee Darren, McClelland Jodie A
School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
BMC Med Educ. 2025 Jul 11;25(1):1042. doi: 10.1186/s12909-025-07559-z.
The assessment of clinical competence is crucial for the education and accreditation of health professionals. Although traditional in-person methods, such as objective structured clinical examinations and case-based clinical assessments are widely used, the COVID-19 pandemic prompted the exploration of online formats. This study examined conducting a clinical case-based assessment in an online environment as an alternative to a traditional in-person assessment for evaluating the competence of internationally trained physiotherapists seeking registration in Australia.
A single-cohort observational study was conducted, where participants completed both online and in-person assessments. Participants were internationally trained physiotherapists seeking registration in Australia. Participants were scored as pass/fail on 8 domains and for overall outcome. Data were analysed by calculating pass/fail rates, absolute agreement, false negative and positive rates and predictive values.
There was a 63% agreement in outcomes between each format, with comparable pass rates (online: 54%, in-person: 68%, p = 0.09). The online assessment demonstrated a strong positive predictive value (79%), indicating its potential to regularly predict competence as determined by the in-person assessment. However, online pass rates were significantly lower than in-person pass rates (60% and 78% respectively, p = 0.04) for the domain that scored competency in hands-on skills.
The findings suggest that online assessment could serve as a viable alternative to the in-person assessment. However, further refinements may be needed to address hands-on skill assessment in online assessments. This study adds to the current evidence base supporting the use of online assessments as an alternative to traditional in-person methods for evaluating clinical competence.
临床能力评估对于卫生专业人员的教育和认证至关重要。尽管传统的面对面评估方法,如客观结构化临床考试和基于案例的临床评估被广泛使用,但新冠疫情促使人们探索在线评估形式。本研究考察了在在线环境中进行基于临床案例的评估,以此作为传统面对面评估的替代方法,用于评估寻求在澳大利亚注册的国际培训物理治疗师的能力。
进行了一项单队列观察性研究,参与者同时完成了在线评估和面对面评估。参与者为寻求在澳大利亚注册的国际培训物理治疗师。根据8个领域和总体结果对参与者进行通过/失败评分。通过计算通过/失败率、绝对一致性、假阴性和阳性率以及预测值来分析数据。
两种评估形式的结果一致性为63%,通过率相近(在线:54%,面对面:68%,p = 0.09)。在线评估显示出较强的阳性预测值(79%),表明其有潜力经常预测由面对面评估确定的能力。然而,在实践技能领域得分合格的情况下,在线通过率显著低于面对面通过率(分别为60%和78%,p = 0.04)。
研究结果表明,在线评估可以作为面对面评估的可行替代方案。然而,可能需要进一步改进以解决在线评估中的实践技能评估问题。本研究为当前支持使用在线评估作为评估临床能力的传统面对面方法的替代方案的证据库增添了内容。