Understanding underperformance in a high-stakes clinical-based simulation assessment in physiotherapy: a descriptive analysis
Abstract Background High-stakes assessments are often used as a ‘gate-keeper’ activity for entry into the health professions by ensuring that the minimum core competency thresholds of the profession are met. The aim of the study was to explore if common areas of underperformance existed in internati...
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Medical Education |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12909-023-04649-8 |
| _version_ | 1797452262545555456 |
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| author | Brooke Flew Belinda Judd Belinda Lange Darren Lee Felicity Blackstock Joanna Tai Kathryn Tognon Lucy Chipchase |
| author_facet | Brooke Flew Belinda Judd Belinda Lange Darren Lee Felicity Blackstock Joanna Tai Kathryn Tognon Lucy Chipchase |
| author_sort | Brooke Flew |
| collection | DOAJ |
| description | Abstract Background High-stakes assessments are often used as a ‘gate-keeper’ activity for entry into the health professions by ensuring that the minimum core competency thresholds of the profession are met. The aim of the study was to explore if common areas of underperformance existed in international candidates assessed with a high-stakes clinical-based simulation assessment for entry into the physiotherapy profession in Australia. Methods A retrospective mixed methods analysis of the clinical assessments completed by international candidates over a one-month period in 2021 that were deemed as not meeting competency. The clinical assessments were completed in one of the three practice areas: cardiorespiratory, musculoskeletal, or neurological rehabilitation. Each assessment was scored by two independent assessors, who discussed the performance and then completed a moderated assessment form. The assessment form used to score competency included seven domains such as initial assessment, effective treatment, communication skills, and risk management. Results Fifty-one clinical assessments graded as not competent were analysed. Across the practice areas, a high failure rate was found in domains related to interpreting assessment findings and developing a treatment plan. This trend was also observed in the qualitative data, suggesting candidates struggled to meet competency in areas of planning and prioritisation, interpretation and implementation of the information gathered, and selection and evaluation of effective treatment. Conclusion These findings align with published data on the underperformance of Australian physiotherapy students in clinical placement settings, suggesting these issues are not specific to high stakes assessment of overseas physiotherapists, and that education needs to focus on improving these skills within the profession at all levels. With the identified areas of underperformance aligning with the ability to use higher order thinking and skills integral to clinical reasoning, improvements in the education and implementation of clinical reasoning may be a place to start. |
| first_indexed | 2024-03-09T15:06:15Z |
| format | Article |
| id | doaj.art-b8f642a695aa4092bf4b1939b6b7ab42 |
| institution | Directory Open Access Journal |
| issn | 1472-6920 |
| language | English |
| last_indexed | 2024-03-09T15:06:15Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj.art-b8f642a695aa4092bf4b1939b6b7ab422023-11-26T13:40:37ZengBMCBMC Medical Education1472-69202023-09-012311810.1186/s12909-023-04649-8Understanding underperformance in a high-stakes clinical-based simulation assessment in physiotherapy: a descriptive analysisBrooke Flew0Belinda Judd1Belinda Lange2Darren Lee3Felicity Blackstock4Joanna Tai5Kathryn Tognon6Lucy Chipchase7School of Allied Health, Human Services and Sport, La Trobe UniversityFaculty of Medicine and Health, The University of SydneyCollege of Nursing and Health Sciences, Flinders UniversityAustralian Physiotherapy CouncilSchool of Health Sciences, Western Sydney UniversityCentre for Research in Assessment and Digital Learning, Deakin UniversityAustralian Physiotherapy CouncilCollege of Nursing and Health Sciences, Flinders UniversityAbstract Background High-stakes assessments are often used as a ‘gate-keeper’ activity for entry into the health professions by ensuring that the minimum core competency thresholds of the profession are met. The aim of the study was to explore if common areas of underperformance existed in international candidates assessed with a high-stakes clinical-based simulation assessment for entry into the physiotherapy profession in Australia. Methods A retrospective mixed methods analysis of the clinical assessments completed by international candidates over a one-month period in 2021 that were deemed as not meeting competency. The clinical assessments were completed in one of the three practice areas: cardiorespiratory, musculoskeletal, or neurological rehabilitation. Each assessment was scored by two independent assessors, who discussed the performance and then completed a moderated assessment form. The assessment form used to score competency included seven domains such as initial assessment, effective treatment, communication skills, and risk management. Results Fifty-one clinical assessments graded as not competent were analysed. Across the practice areas, a high failure rate was found in domains related to interpreting assessment findings and developing a treatment plan. This trend was also observed in the qualitative data, suggesting candidates struggled to meet competency in areas of planning and prioritisation, interpretation and implementation of the information gathered, and selection and evaluation of effective treatment. Conclusion These findings align with published data on the underperformance of Australian physiotherapy students in clinical placement settings, suggesting these issues are not specific to high stakes assessment of overseas physiotherapists, and that education needs to focus on improving these skills within the profession at all levels. With the identified areas of underperformance aligning with the ability to use higher order thinking and skills integral to clinical reasoning, improvements in the education and implementation of clinical reasoning may be a place to start.https://doi.org/10.1186/s12909-023-04649-8Clinical reasoningHigh-stakes assessmentOverseas qualified physiotherapistsUnderperformance |
| spellingShingle | Brooke Flew Belinda Judd Belinda Lange Darren Lee Felicity Blackstock Joanna Tai Kathryn Tognon Lucy Chipchase Understanding underperformance in a high-stakes clinical-based simulation assessment in physiotherapy: a descriptive analysis BMC Medical Education Clinical reasoning High-stakes assessment Overseas qualified physiotherapists Underperformance |
| title | Understanding underperformance in a high-stakes clinical-based simulation assessment in physiotherapy: a descriptive analysis |
| title_full | Understanding underperformance in a high-stakes clinical-based simulation assessment in physiotherapy: a descriptive analysis |
| title_fullStr | Understanding underperformance in a high-stakes clinical-based simulation assessment in physiotherapy: a descriptive analysis |
| title_full_unstemmed | Understanding underperformance in a high-stakes clinical-based simulation assessment in physiotherapy: a descriptive analysis |
| title_short | Understanding underperformance in a high-stakes clinical-based simulation assessment in physiotherapy: a descriptive analysis |
| title_sort | understanding underperformance in a high stakes clinical based simulation assessment in physiotherapy a descriptive analysis |
| topic | Clinical reasoning High-stakes assessment Overseas qualified physiotherapists Underperformance |
| url | https://doi.org/10.1186/s12909-023-04649-8 |
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