| Abstract/Notes |
INTRODUCTION: The Council for Chiropractic Education has set standards for skill and knowledge (e.g. CCE competencies) in neuromusculoskeletal examination which includes the ability to choose appropriate testing procedures based upon patient complaint; the ability to recognize and interpret significant findings; and the ability to choose appropriate confirmatory tests. Customarily, practical examination testing for orthopedic courses has been graded in a holistic fashion (all or nothing) in which the student must perform the test correctly, state the correct positive sign, and state the correct indication. This grading scheme does not provide a formative assessment to discriminate strengths and weaknesses. Analytical rubric scoring methods have been devised as formative assessments in education for this purpose. At Life University, College of Chiropractic, a work group was formed to develop individual class rubrics to assess strengths and weaknesses in these performance standards. Our purpose is to describe the design and testing of a rubric scoring method for the practical testing for neuromusculoskeltal examination. METHODS: Each of the 31 students was graded on performance by the usual holistic method. In addition, a formative assessment was utilized in an attempt to discriminate the student’s ability to choose appropriate testing procedures, state the correct positive sign, state the correct indication, and choose appropriate confirmatory procedures using a rubric scoring method. In the rubric, knowledge levels were set such that the ability to demonstrate the preceding skills 70-79% of the time was basic, 80-89% was advanced, and 90-100% was mastery. CCE skill competency in use of equipment in neuromusculoskeletal examination was added. Basic competence was correct equipment use, advanced; safe use, and mastery; hygienic use. Additionally CCE skill competency in patient interaction was included. Basic competence was the ability to give patient instructions during the exam, advanced; the ability to adequately explain equipment use, and mastery; obtaining patient consent, demonstration of empathy, and recognition of the importance of confidentiality. The two scores and a combination of these scores for the 31 students in the class were compared to the overall score using a Pearson product-moment coefficient correlation and a multiple regression analysis in Excel. RESULTS: The mean holistic score (grade) was 78%. The knowledge component mean was 79%, the skill component mean was 90% and the mean for the combination skill and knowledge components was 82% for this convenience sample. The knowledge component of the rubric demonstrated a 0.73 correlation when compared to the grade and the skill component demonstrated a 0.66 when compared to the grade. When combined knowledge and skill were compared to the student’s overall score the correlation was 0.80. The regression analysis compared skills and knowledge components against the overall score, giving R = 0.81(standard error 7.13). DISCUSSION: Student performance as scored by these two methods demonstrate high correlation. The rubric scoring method is demonstrated to be an effective way to provide formative assessment of knowledge and skills in the neuromusculoskeletal examination. This abstract is reproduced with the permission of the publisher. |
