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Inter-rater Agreement on Final Competency Testing Utilizing Standardized Patients.

Dixie H Bowman1, Kyle L Ferber, Adam P Sima

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Licensed physical therapists acting as standardized patients (SPs) did not evaluate physical therapy students as rigorously as instructors, particularly on practical exams. This suggests SPs may not fully replace instructors in assessing student competency.

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Area of Science:

  • Medical Education
  • Physical Therapy Assessment

Background:

  • Standardized patients (SPs) are increasingly used in medical education for practical examinations.
  • Ensuring equivalent evaluation between SPs and instructors is crucial for valid student assessment.

Purpose of the Study:

  • To compare the evaluation consistency of licensed physical therapists serving as SPs versus a course instructor when assessing physical therapy students.
  • To determine if SPs provide equivalent grading to instructors in physical therapy competency testing.

Main Methods:

  • Eight licensed physical therapists acted as SPs for 51 physical therapy students.
  • SPs and one instructor completed identical assessments based on set criteria.
  • Paired t-tests and intraclass correlation coefficients (ICC) analyzed score differences for practical exams, question answers, and documentation.

Main Results:

  • The instructor awarded significantly higher scores for the practical exam and overall performance compared to SPs.
  • No significant differences were found between instructor and SP scores for question answers and documentation notes.

Conclusions:

  • Physical therapists serving as SPs may not be suitable replacements for instructors in grading all aspects of physical therapy student competency tests.
  • Inter-rater reliability between SPs and instructors needs further investigation for comprehensive student evaluation.