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Biomedical subjects

Elspeth Finch

Publications and source records attributed to Elspeth Finch.

2 recordsLinked to original sources

Reliability and validity of an objective structured clinical examination for physical therapy students.

The purpose of this study was to examine the reliability and validity of an objective structured clinical examination (OSCE) for students in the first year of a 2-year physical therapy program. Forty-eight students were examined at eight stations in one of two duplicate OSCE circuits. The stations evaluated skills required for the management of persons with chronic musculoskeletal conditions. At each station, students were required to interact with patients, demonstrate techniques, or interpret observations. Checklists were used to score all stations, which had equal values. The associations among stations were examined using Pearson's correlations and Cronbach's alpha. A two-way analysis of variance (ANOVA) with repeated measures was used to determine differences among stations and between circuits. The validity of the OSCE was evaluated by determining the correlations between scores on the stations and performance in a subsequent clinical practicum. Correlations between stations were r = -0.14 to 0.33 and between stations and clinical performance were r = -0.28 to 0.27. Cronbach's alpha was 0.48. The ANOVA revealed significant differences among stations (F = 62.6, p = 0.000) but not between circuits (F = 1.8, p = 0.185). There was no significant interaction between circuit and station (F = 1.1, p = 0.356). There was poor internal consistency of the OSCE, and it did not predict clinical performance. Further research is required to determine if a larger number of stations can reliably and validly assess clinical skills of physical therapy students.

Canada↗

Ethically-based clinical decision-making in physical therapy: process and issues.

The identification and consideration of relevant ethical issues in clinical decision-making, and the education of health care professionals (HCPs) in these skills are key factors in providing quality health care. This qualitative study explores the way in which physical therapists (PTs) integrate ethical issues into clinical practice decisions and identifies ethical themes used by PTs. A purposive sample of eight PTs was asked to describe a recent ethically-based clinical decision. Transcribed interviews were coded and themes identified related to the following categories: 1) the integration of ethical issues in the clinical decision-making process, 2) patient welfare, 3) professional ethos of the PT, and 4) health care economics and business practices. Participants readily described clinical situations involving ethical issues but rarely identified specific conflicting ethical issues in their description. Ethical dilemmas were more frequently resolved when there were fewer emotional sequelae associated with the dilemma, and the PT had a clear understanding of professional ethos, valued patient autonomy, and explored a variety of alternative actions before implementing one. HCP students need to develop a clear professional ethos and an increased understanding of the economic factors that will present ethical issues in practice.

Adult↗