Although participation in continuing education activities is the most widely accepted method of upgrading professional training in the area of seating and mobility, the impact of these educational experiences has yet to be documented. Specifically, reliable and valid measures of the outcomes of educational experiences or clinical practice on the ability to make specialized clinical decisions are needed. This dissertation is comprised of a series of three, inter-related studies, which, develop and validate the Seating and Mobility Script Concordance Test (SMSCT); a performance-based measure intended for use with professionals that recommend seating and mobility devices to individuals with spinal cord injuries. The SMSCT is designed to assess clinicians by examining the organization of their knowledge, associations between items of their knowledge, and adequacy of their clinical decisions compared to expert consensus. The first study presents the conceptual foundation, item generation process, and content validity evidence leading to the final version of the SMSCT. Results indicate that the 67-item SMSCT adequately represents the dimensions of assessment and intervention knowledge for seating and mobility for spinal cord injury. In the second study, 15 spinal cord injury experts assisted with the development of the scoring system, and 100 physical and occupational therapists were used for obtaining internal and external validity evidence. Appraisal of the technical quality of the test showed reasonable item performance, with some items performing better than others. Other evidence showed the SMSCT distinguished between intervention subscores for two groups of known differences. Proxy measures of clinical expertise on the whole did not prove to be strong predictors of SMSCT scores for a population of clinicians with varying amounts of seating and mobility experience. The third study, comprised of 50 seating and mobility clinicians, further explored the validity of the SMSCT as a measure of educational effectiveness. No one proxy measure of clinical expertise accounted for a considerable change in posttest scores following an educational program. Changes in SMSCT scores were detected following an educational program. Initial psychometric testing maintains that the SMSCT is a promising measure of seating and mobility clinical expertise. Further SMSCT development, revision and validation are needed.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-12022003-164844 |
| Date | 10 December 2003 |
| Creators | Cohen, Laura J. |
| Contributors | Suzanne Lane, Michael Boninger, Shirley Fitzgerald, Michael McCue, Jean Minkel |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-12022003-164844/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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