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Criterion scores construct validity and reliability of a web-based instrument to assess physiotherapists clinical reasoning focused on behaviour change: ‘Reasoning 4 Change’

机译:一种基于网络的工具的标准评分结构效度和可靠性用于评估针对行为改变的物理治疗师的临床推理:推理4改变

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摘要

Background and aim: ‘Reasoning 4 Change’ (R4C) is a newly developed instrument, including four domains (D1–D4), to assess clinical practitioners' and students' clinical reasoning with a focus on clients' behaviour change in a physiotherapy context. To establish its use in education and research, its psychometric properties needed to be evaluated. The aim of the study was to generate criterion scores and evaluate the reliability and construct validity of a web-based version of the R4C instrument. Methods: Fourteen physiotherapy experts and 39 final-year physiotherapy students completed the R4C instrument and the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT). Twelve experts and 17 students completed the R4C instrument on a second occasion. The R4C instrument was evaluated with regard to: internal consistency (five subscales of D1); test-retest reliability (D1–D4); inter-rater reliability (D2–D4); and construct validity in terms of convergent validity (D1.4, D2, D4). Criterion scores were generated based on the experts' responses to identify the scores of qualified practitioners' clinical reasoning abilities. Results: For the expert and student samples, the analyses demonstrated satisfactory internal consistency (α range: 0.67–0.91), satisfactory test-retest reliability (ICC range: 0.46–0.94) except for D3 for the experts and D4 for the students. The inter-rater reliability demonstrated excellent agreement within the expert group (ICC range: 0.94–1.0). The correlations between the R4C instrument and PABS-PT (r range: 0.06–0.76) supported acceptable construct validity. Conclusions: The web-based R4C instrument shows satisfactory psychometric properties and could be useful in education and research. The use of the instrument may contribute to a deeper understanding of physiotherapists' and students' clinical reasoning, valuable for curriculum development and improvements of competencies in clinical reasoning related to clients' behavioural change.
机译:背景和目的:“推理4改变”(R4C)是一种新开发的工具,包括四个领域(D1-D4),用于评估临床医生和学生的临床推理,重点是在理疗环境中客户的行为改变。为了确定其在教育和研究中的用途,需要评估其心理测量特性。该研究的目的是生成标准评分,并评估基于Web的R4C仪器的可靠性和结构效度。方法:14位理疗专家和39名最后一年的理疗学生完成了R4C仪器和理疗师的疼痛态度和信念量表(PABS-PT)。 12名专家和17名学生第二次完成了R4C仪器。对R4C仪器进行了以下方面的评估:内部一致性(D1的五个子量表);重测可靠性(D1-D4);评估者之间的可靠性(D2-D4);并根据收敛效度(D1.4,D2,D4)构造效度。根据专家的回答生成标准分数,以识别合格从业人员的临床推理能力的分数。结果:对于专家和学生样本,分析显示令人满意的内部一致性(α范围:0.67–0.91),令人满意的重测信度(ICC范围:0.46-0.94),专家D3和学生D4除外。评估者之间的可靠性在专家组内显示出极好的一致性(ICC范围:0.94–1.0)。 R4C仪器和PABS-PT之间的相关性(r范围:0.06-0.76)支持可接受的构建体有效性。结论:基于Web的R4C仪器显示出令人满意的心理测量特性,可用于教育和研究。仪器的使用可能有助于更深入地理解理疗师和学生的临床推理,对于课程开发和与客户行为改变相关的临床推理能力的提高具有宝贵的意义。

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