Establishing assessment criteria for clinical reasoning in orthopedic manual physical therapy: a consensus-building study

Abstract

Objectives: Clinical reasoning (CR) represents one of the core components of clinical competence in Orthopaedic Manual Physical Therapy (OMPT). While education standards have been developed to guide curricular design, assessment of CR has not yet been standardized. Without theory-informed and rigorously developed measures, the certification of OMPTs lacks credibility and is less defensible. The purpose of this study was to use a theory-informed approach to generate assessment criteria for developing new assessment tools to evaluate CR in OMPT. Methods: A list of assessment criteria was generated based on international education standards and multiple theoretical perspectives. A modified Delphi method was used to gain expert consensus on the importance of these assessment criteria for the assessment of CR in OMPT. The OMPTs from 22 countries with experience in assessing CR were invited to participate in three rounds of online questionnaires to rate their level of agreement with these criteria. Responses were tabulated to analyze degree of consensus and internal consistency. Results: Representatives from almost half of the OMPT member organizations (MO) participated in three rounds of the Delphi. High levels of agreement were found among respondents regarding the importance and feasibility of most assessment criteria. There was high internal consistency among items within the proposed item subgroupings. Discussion: A list of assessment criteria has been established that will serve as a framework for developing new assessment tools for CR assessment in OMPT. These criteria will be important for guiding the design of certification processes in OMPT as well as other episodes of CR assessment throughout OMPT training.

Validity of a new assessment rubric for a short-answer test of clinical reasoning

“…To improve current methods, the CHAT was developed to assess the written responses to this test in order to determine candidates’ clinical reasoning competence in a more standardized and comprehensive manner [ 11 ]. The assessment items within the CHAT were constructed and assigned to each of the 16 short-answer questions based on the clinical reasoning domain(s) represented in each question.…”

“…The CHAT was developed to improve the manner in which the construct of clinical reasoning is assessed through a short-answer test in OMPT. The CHAT was based on a previously published clinical reasoning assessment framework that describes the construct of clinical reasoning in OMPT; details regarding the development of this framework are published elsewhere [ 11 ].…”

Using the diagnostic thinking inventory in musculoskeletal physiotherapy: a validity and reliability study

“…It was demonstrated that expert musculoskeletal physiotherapists have superior diagnostic reasoning skills when compared to novices (Doody & McAteer, 2002; Gobet & Borg, 2011). As a result, diagnostic clinical reasoning constituted a fundamental part of competency assessment of practitioners enrolled in master's level musculoskeletal physiotherapy education (Rushton, Beeton, Jordaan, & Pool, 2016; Rushton & Lindsay, 2010; Yeung, Woods, Dubrowski, Hodges, & Carnahan, 2015). In their exploratory case study, Rushton and Lindsay (2010) identified the important diagnostic reasoning constructs within the curriculum of master's level musculoskeletal physiotherapy programme, namely: identifying cues; pattern recognition; hypothetico‐deduction; specificity; prioritisation, integrating different sources of evidence; creativity and lateral thinking; flexibility and multitasking.…”

An online model of international clinical mentoring for novice physical therapists

“…Modern technology and globalization within educational settings can facilitate the development of new models of delivering clinical mentoring that can better meet the needs of today's clinicians around the globe. There has been a recent call in the literature for educational research in physical therapy [22], and research examining the effectiveness of educational interventions to promote professional development [23]. Therefore, research exploring innovative clinical mentoring strategies to reduce barriers and enhance professional development is needed.…”