DEVELOPMENT AND VALIDITY OF AN INNOVATIVE TEST TO ASSESS GUIDELINE-CONSISTENT CLINICAL REASONING BY PHYSICAL THERAPISTS IN STROKE REHABILITATION

Abstract

Objective: To evaluate the validity of a script concordance test to assess guideline-consistent clinical reasoning by physical therapists in stroke rehabilitation, and to identify critical features of physical therapists specializing in stroke rehabilitation.Methods: A script concordance test was developed according to current standards. Four subgroups of physical therapists (those specializing in neurology, those focusing on neurology or geriatrics, other, and non-specialized undergraduate students) were asked to complete the test. The construct validity of the script concordance test was evaluated with 1-way analysis of variance (ANOVA) to estimate differences between subgroups. Associations between physical therapist characteristics, and script concordance test scores were analysed with bivariate regression analysis followed by multivariate analyses.Results: The script concordance test, with 59 items, was completed by 211 physical therapists. ANOVA analysis showed statistically significant differences between the script concordance test scores of the 4 groups (p<0.001), with higher scores by the physical therapists specializing in neurology compared with the other, non-specialized, subgroups. The multivariate analysis showed that better guideline knowledge (B=1.07; CI=0.48-1.65; p=<0.001), successful completion of the Dutch Neurorehabilitation course (B = 4.1; CI= 1.37-6.87; p= 0.003), and participation in professional development activities (B = 2.4; CI= 0.05-4.68; p = 0.046) were associated with higher script concordance test scores.Conclusion: The script concordance test has good construct validity. Greater self-reported guideline knowledge, successful completion of the post-bachelor Dutch Neurorehabilitation course, as well as systematic participation in professional development activities facilitate important factors that enhance specialization. The script concordance test is a valid feedback tool for physical therapists to support professional development in the domain of stroke rehabilitation.