Item – Theses Canada

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OCLC number
275811137
Link(s) to full text
LAC copy
LAC copy
Author
Pereira, Jose L.(Jose Luis),1963-
Title
The development and psychometric assessment of an instrument to assess palliative care competencies.
Degree
M. Sc. -- University of Calgary, 2006
Publisher
Ottawa : Library and Archives Canada = Bibliothèque et Archives Canada, [2007]
Description
2 microfiches
Notes
Includes bibliographical references.
Abstract
In 2004, 3 OSCE stations were developed to assess the impact of a palliative care course on the competencies of rural family medicine residents. Instruments were also developed to assess the knowledge, attitudes and self-perceived comfort levels of the residents. The results of this pilot project guided the further development of these assessment instruments in 2005. This study aimed to evaluate the psychometric properties of the instruments developed, with specific focus on the OSCES, and to begin the development of a generic standardized OSCE scoring system for palliative care competencies. The OSCE scoresheets consisted of an itemized checklist and a global scale. The impact of the course on knowledge, attitudes and comfort levels were secondary aims. A total of 20 and 16 residents participated in the 2005 pre- and post-course OSCEs, respectively, and completed the other assessment tools. The internal-reliability values of the OSCE scales ranged from 0.65 to 0.82 across the 3 stations, pre- and post-course. Face validity appeared high as demonstrated by feedback from the family medicine residents and palliative care physicians. The correlations between the total checklist scores and the Global scores were significant (r=0.47 to =.77; p=0.001 to p=0.07). Inter-item coefficient correlations identified several items that appeared redundant and others that provided evidence for divergent and convergent validity of the scale. Significant improvements were noted in OSCE 2 pre and post-course (t=3.14 and 0.01, p=0.01, d effect sizes of 1.42 and 1.94 respectively). The effect sizes in the other stations ranged from d=0.21 to 1.34. There were significant improvements in knowledge levels pre-versus post-course (t=4.44 and 8.99 in the 2004 and 2005 courses; effect sizes respectively were d=2.29 and 2.24). The 16-item knowledge scale however had a low internal reliability of 0.29. The Attitudinal Scale's (12 items) internal reliability was 0.68 and the Comfort Scales's 0.92 (22 items). A generic standardized palliative care OSCE assessment instrument, the Palliative Care-OSCE Scale (Pal-OSCEs), is proposed on the basis of the data and experience derived from the results. Pal-OSCEs will facilitate scoring of Palliative Care OSCEs across many domains and serve as a learning tool for residents. An assessment framework for palliative care education interventions that includes assessment of competencies at knowledge, attitudes and skill levels is suggested. The benefits of including a self-perceived comfort assessment are unclear. Although assessment methods with high validity and reliability to assess these domains are advised, practicalities such as cost, time constraints and lack of sufficient numbers of faculty assessors pose a challenge, often requiring some compromises.
ISBN
9780494192566
0494192569