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Assessing clinical competence: a multitrait-multimethod matrix construct validity study.
Andrea Vallevand1, David E Manthey2, Kim Askew2
1Wake Forest University School of Medicine, Winston-Salem, USA. avalleva@wakehealth.edu.
This study applied advanced statistical methods to assess medical students' clinical skills. The multitrait-multimethod matrix analysis demonstrated the validity of these assessments, particularly for professionalism.
Area of Science:
- Medical Education
- Psychometrics
- Health Professions Education
Background:
- Medical education increasingly focuses on clinical competency.
- Entrustable Professional Activities (EPAs) provide a framework for assessing clinical skills.
- Current clinical skills assessment methods often lack rigorous validation.
Purpose of the Study:
- To investigate the construct validity of clinical skills assessments in medical education.
- To apply the multitrait-multimethod matrix analysis to evaluate multiple assessment methods.
- To explore the reliability and validity of assessing critical clinical skills.
Main Methods:
- Operationalized four traits: professionalism, data gathering, data synthesis, and data delivery.
- Assessed traits using three methods: direct observation, workplace-based evaluations, and objective structured clinical examinations.
- Employed multitrait-multimethod matrix analysis to intercorrelate traits and methods.
Main Results:
- Reliability values ranged from adequate to good across assessment methods.
- Most validity coefficients were statistically significant.
- Professionalism showed the clearest convergent and divergent validity.
- A substantial method effect was observed, especially in workplace-based assessments.
Conclusions:
- The multitrait-multimethod matrix approach is a valuable, underutilized tool for assessing complex constructs like clinical skills in medical education.
- Findings can inform faculty development to enhance the reliability and validity of clinical assessments.
- Improved assessment validity is crucial for ensuring clinical competency in medical professionals.

