Competency-based assessments for healthcare professionals are critical for safe and effective client outcomes. Rehabilitation clinical skill competency assessments must be validated and revised to produce safe and ski...Competency-based assessments for healthcare professionals are critical for safe and effective client outcomes. Rehabilitation clinical skill competency assessments must be validated and revised to produce safe and skilled practitioners. The revised American Occupational Therapy Association (AOTA) Fieldwork Performance Evaluation (FWPE) instrument measures occupational therapy student performance to determine readiness for practice. The assessment includes thirty-seven competencies that address both profession specific clinical skills and general professional behavior skills. The objective of this study was to use Rasch methods to explore the use of the revised FWPE in actual fieldwork practice and to determine the instrument’s psychometric properties when separating the item components into two distinct subdomains: General Health Professions Competences and Occupational Therapy-Specific Competencies. Internal construct validity and test reliability were analyzed using data from 149 occupational therapy students after completing their initial Level II A fieldwork clinical internship. This study examined the item difficulty hierarchy, item fit, person-fit to model, person separation index, person separation reliability coefficient, strata, ceiling and floor effect, and unidimensionality of the FWPE instrument as a whole and as two separate domains. With the exception of not meeting the criteria for unidimensionality, the full FWPE instrument and the Occupational Therapy-Specific Competencies subdomain showed acceptable item-level psychometrics for reliability and precision. While the General Health Professions Competencies subdomain showed good item-level psychometrics, it was below the criterion for reliability and only separated the sample into two strata. Results support the validity, reliability, and clinical use of the revised FWPE full instrument and the Occupational Therapy-Specific Competencies subdomain to measure entry-level clinical skill competencies in practice.展开更多
目的评估中文版患者报告结局测量信息系统(Patient Reported Outcome Measurement Information System,PROMIS)癌症特异性抑郁项目库的心理测量学属性,构建计算机自适应测试版本(PROMIS Cancer Depression CAT),并评价其效果。方法采用...目的评估中文版患者报告结局测量信息系统(Patient Reported Outcome Measurement Information System,PROMIS)癌症特异性抑郁项目库的心理测量学属性,构建计算机自适应测试版本(PROMIS Cancer Depression CAT),并评价其效果。方法采用便利抽样法选取2020年11月—2021年7月在上海2所三级甲等医院的648例癌症患者作为研究对象。在心理测量学评估中,首先基于Rasch模型采用残差的主成分分析、条目残差相关系数、条目特征曲线检验PROMIS癌症特异性抑郁项目库的单维性、局部独立性、单调性假设;其次,通过Rasch模型中的选项特征曲线对选项进行拟合,采用Rasch模型中的Infit MNSQ、Outfit MNSQ、难度参数对每个条目进行拟合;最后,将经过校准后的项目库内容作为PROMIS Cancer Depression CAT的题库,采用Post-hoc模拟方法评价PROMIS Cancer Depression CAT的测量效率和准确性。结果PROMIS癌症特异性抑郁项目库由测试解释的经验方差为68.6%,条目之间的残差相关值都小于0.70,条目特征曲线是单调递增曲线。PROMIS癌症特异性抑郁项目库中的5个选项的峰值均未被相邻选项的特征曲线覆盖,5个选项之间阈值的间隔均大于1且小于5,条目的Infit MNSQ值为[0.54,1.49],Outfit MNSQ值为[0.55,1.49],选项和条目的拟合均在理想范围内,可作为构建PROMIS Cancer Depression CAT的项目库。Post-hoc模拟执行CAT的θ值与整个项目库的θ值相关系数为0.964,选择的平均使用条目数为6.348个。结论中文版PROMIS癌症特异性抑郁项目库满足单维性、局部独立性以及单调性假设,可以用来构建PROMIS Cancer Depression CAT。基于PROMIS癌症特异性抑郁项目库参数构建的计算机自适应测试版本能够高效、准确地测量癌症患者的抑郁水平。展开更多
文摘Competency-based assessments for healthcare professionals are critical for safe and effective client outcomes. Rehabilitation clinical skill competency assessments must be validated and revised to produce safe and skilled practitioners. The revised American Occupational Therapy Association (AOTA) Fieldwork Performance Evaluation (FWPE) instrument measures occupational therapy student performance to determine readiness for practice. The assessment includes thirty-seven competencies that address both profession specific clinical skills and general professional behavior skills. The objective of this study was to use Rasch methods to explore the use of the revised FWPE in actual fieldwork practice and to determine the instrument’s psychometric properties when separating the item components into two distinct subdomains: General Health Professions Competences and Occupational Therapy-Specific Competencies. Internal construct validity and test reliability were analyzed using data from 149 occupational therapy students after completing their initial Level II A fieldwork clinical internship. This study examined the item difficulty hierarchy, item fit, person-fit to model, person separation index, person separation reliability coefficient, strata, ceiling and floor effect, and unidimensionality of the FWPE instrument as a whole and as two separate domains. With the exception of not meeting the criteria for unidimensionality, the full FWPE instrument and the Occupational Therapy-Specific Competencies subdomain showed acceptable item-level psychometrics for reliability and precision. While the General Health Professions Competencies subdomain showed good item-level psychometrics, it was below the criterion for reliability and only separated the sample into two strata. Results support the validity, reliability, and clinical use of the revised FWPE full instrument and the Occupational Therapy-Specific Competencies subdomain to measure entry-level clinical skill competencies in practice.
文摘目的评估中文版患者报告结局测量信息系统(Patient Reported Outcome Measurement Information System,PROMIS)癌症特异性抑郁项目库的心理测量学属性,构建计算机自适应测试版本(PROMIS Cancer Depression CAT),并评价其效果。方法采用便利抽样法选取2020年11月—2021年7月在上海2所三级甲等医院的648例癌症患者作为研究对象。在心理测量学评估中,首先基于Rasch模型采用残差的主成分分析、条目残差相关系数、条目特征曲线检验PROMIS癌症特异性抑郁项目库的单维性、局部独立性、单调性假设;其次,通过Rasch模型中的选项特征曲线对选项进行拟合,采用Rasch模型中的Infit MNSQ、Outfit MNSQ、难度参数对每个条目进行拟合;最后,将经过校准后的项目库内容作为PROMIS Cancer Depression CAT的题库,采用Post-hoc模拟方法评价PROMIS Cancer Depression CAT的测量效率和准确性。结果PROMIS癌症特异性抑郁项目库由测试解释的经验方差为68.6%,条目之间的残差相关值都小于0.70,条目特征曲线是单调递增曲线。PROMIS癌症特异性抑郁项目库中的5个选项的峰值均未被相邻选项的特征曲线覆盖,5个选项之间阈值的间隔均大于1且小于5,条目的Infit MNSQ值为[0.54,1.49],Outfit MNSQ值为[0.55,1.49],选项和条目的拟合均在理想范围内,可作为构建PROMIS Cancer Depression CAT的项目库。Post-hoc模拟执行CAT的θ值与整个项目库的θ值相关系数为0.964,选择的平均使用条目数为6.348个。结论中文版PROMIS癌症特异性抑郁项目库满足单维性、局部独立性以及单调性假设,可以用来构建PROMIS Cancer Depression CAT。基于PROMIS癌症特异性抑郁项目库参数构建的计算机自适应测试版本能够高效、准确地测量癌症患者的抑郁水平。
