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Development of a script concordance test in hand rehabilitation: Methodological process and preliminary validation
Etienne Panchout1, Salomé Richard1, Marie-Charlotte Branchet2
1ERCAE Associate Researcher (UR 7493), Université d'Orléans, France.
Introduction:
This article describes the development and use of a script concordance test (SCT) to assess and certify the expertise of members of the French professional association specialising in hand and upper limb rehabilitation, orthotics and prosthetics: SFRM-GEMMSOR, which brings together physiotherapy and occupational therapy experts in hand rehabilitation. Their expertise is assessed on a combination of training, clinical experience and contextual analysis. The SCT was designed to document this expertise and guarantee recognised certification.
Methods:
The PAF2S® company was asked to design the SCT, with a team of three health education experts. Ten writers and sixteen expert panellists produced 67 clinical vignettes and 227 items, aiming to reflect the diversity of hand rehabilitation cases. After optimisation, 59 vignettes and 200 items were chosen. Sixty-one items were selected to create an SCT which was then tested on 24 rehabilitation specialists at the 60th conference of the French Society for Surgery of the Hand (SFCM). Following analysis of the results, poorly discriminating items were adjusted, and the internal consistency of the test was assessed with a Cronbach's alpha level of 0.88, indicating strong reliability.
Results:
The experts achieved a mean correct response rate of 77.1% (standard deviation: 5.2%), vs. 66.1% achieved by participating rehabilitation specialists (standard deviation: 5.7%). A threshold of 56.3% allowed 23 out of 24 participants to pass the test.
Discussion:
The study highlights the value of the SCT for assessing expertise in hand rehabilitation, while revealing biases and limitations related to the composition of the expert panel and the simulated clinical reasoning process. The SCT offers more than simple certification, with possible applications in continuing professional development, classifying standards of expertise within SFRM-GEMMSOR and identifying practitioners' professional development needs.
Conclusion:
The SCT is a valuable instrument for documenting and structuring clinical expertise in hand rehabilitation, opening up new prospects for improving clinical reasoning and recognition of professional skills within SFRM-GEMMSOR.
