Clinical competence is generally defined as a combination of knowledge, skill and professional behaviour. It is typically assessed using written tests, direct observation, chart audit, client satisfaction surveys and supervisor ratings. This paper describes the development and evaluation of a chart-stimulated recall (CSR) measure that combines the methods of chart audit and clinician interview to assess the clinical competence of practicing occupational therapists. The CSR tool was developed using the Canadian Guidelines for Client-Centred Practice and taps global domains of competence: use of theory, assessment, program planning, intervention, discharge planning, follow-up, program evaluation, clinical reasoning and professional behaviours. This pilot study involved two independent raters/interviewers who assessed twelve occupational therapy clinicians on two occasions using a random sample of client cases/records on each occasion Results indicate that the CSR tool is not only reliable and valid, but also sufficiently generic to be used in a variety of practice settings as a global measure of on-the-job performance.
BaumC.M.GrayM.S. (1988). Certification: Serving the public interest. American Journal of Occupational Therapy, 42, 77–79.
2.
BorgeilA.E.M.WilliamsJ.I.BassM.J.DunnE.V.EvansenM.K.LamontC.T.MacDonaldP.J.McCoyJ.M.SpasoffR.A. (1989). Quality of care in family practice: Does residency training make a difference?Canadian Medical Association Journal, 140, 1035–1943.
3.
BridleM.J. (1977). Profile of an occupational therapist: A report on the project to date. Canadian Journal of Occupational Therapy, 45, 23–25.
4.
Canadian Association of Occupational Therapists. (1991a). Occupational therapy guidelines for client-centered practice. Toronto, ON: CAOT Publications ACE.
5.
Canadian Association of Occupational Therapists. (1991b). Certification examination for occupational therapists: Application procedures and examination format. Toronto, ON: CAOT Publications ACE.
6.
CoatesV. E.ChambersM. (1992). Evaluation of tools to assess clinical competence. Nurse Education Today, 12, 122–129.
7.
CunningtonJ.KeaneD. (1996–1997). The Physician Review Program. Pedagogue, 7(1): 1–6. (Available from the Program for Educational Development in the Faculty of Health Sciences at McMaster University in Hamilton, Ontario).
8.
CunningtonJ.P.W.HannaE.TurnbullJ.KaigasT.B.NormanG.R. (1997). Defensible assessment of the competency of the practicing physician. Academic Medicine, 72, 9–12.
9.
DixonW.J.BrownM.B.EngelmanL.FraneJ.W.HillM.A.JennrichR.I.ToporekJ.D. (1983). Biomedical Computer Programs, BMDP. Berkley, CA: University of California Press.
10.
EdwardsM.BaptisteS. (1987). The occupational therapist as a clinical teacher. Canadian Journal of Occupational Therapy, 54, 249–255.
11.
EisenburgJ.M. (1989). Evaluating internists' clinical competence. Journal of General Internal Medicine, 4, 139–143.
12.
ElsteinA.S.ShulmanL.S.SprafkaS.A. (1978). Medical problem solving: An analysis of clinical reasoning. Cambridge, MA: Harvard University Press.
13.
ErnestM.PolatajkoH. (1986). Performance evaluation of occupational therapy students: A validity study. Canadian Journal of Occupational Therapy, 53, 265–271.
14.
FearingV.G. (1993). Occupational therapists chart a course through the health record. Canadian Journal of Occupational Therapy, 60, 232–240.
15.
FidlerJ.R. (1993). An application of practical strategies in assessing criterion-related validity of credentialling examinations. Evaluation and the Health Professions, 16, 13–43.
16.
GaitoJ. (1982). Measurement scales and statistics: Resurgence of an old misconception. Psychological Bulletin, 87, 564–567.
17.
GillT. (1984). Professional certification procedures: A developmental forecast for the year 2000. Canadian Journal of Occupational Therapy, 51, 31–36.
18.
GoldmanR. (1994). The reliability of peer assessments. Evaluation and the Health Professions, 17, 3–21.
19.
HagerP.GoncziA. (1996). What is competence?Medical Teacher, 18, 15–19.
20.
HawkesB. (1985). The certification examination - how does it affect you?Canadian Journal of Occupational Therapy, 52, 185–187.
21.
KaneM. (1994). Validating interpretive arguments for licensure and certification examinations. Evaluation and the Health Professions, 17, 133–159.
22.
KeynanA.FriedmanM.BenbassatJ. (1987). Reliability of global rating scales in the assessment of clinical competence in medical students. Medical Education, 21, 477–481.
23.
MarkertR.J. (1993). The relationship of academic measures in medical school to performance after graduation. Academic Medicine, 68, S31–S34.
24.
MarshallJ. (1993). Assessment during post graduate training. Academic Medicine, 68, S23–S26.
25.
MissiunaC.PolatajkoH.Ernest-ConibearM. (1992). Skills acquisition during fieldwork placements in occupational therapy. Canadian Journal of Occupational Therapy, 59, 28–39.
26.
NorciniJ.J.WebsterG.D.GrosoC.J.BlankL.L.BensonJ.A. (1987). Ratings of residents' clinical competence and performance on certification examinations. Journal of Medical Education, 62, 457–462.
27.
NormanG.R.DavisD.A.LambS.HannaE.CaulfordP.KaigasT. (1993). Competency assessment of primary care physicians as part of a peer review program. Journal of the American Medical Association, 270, 1046–1051.
28.
NormanG.R. (1991). Can an examination predict competence? The role of recertification in maintenance of competence. Annals of the Royal College of Physicians and Surgeons Canada, 24, 121–124.
29.
NormanG.R. (1985). Implications for research. In NeufeldV.R.NormanG.R., Assessing Clinical Competence (pp. 330–341). New York: Springer Publishing.
30.
OgnibeneA.J.JarjouraD.G.IlleraV.A.BlendD.A.CuginoA.E.ThittierF.C. (1994). Using chart reviews to assess resident's performances of components of physical examinations: A pilot study. Academic Medicine, 69, 583–587.
31.
PageG.P.BatesJ.DyerS.D.VincentD.R.BordageG.JacquesA.SindonA.KaigasT.NormanG.R.KopelowM.MoranJ. (1995). Physican-assessment and physician-enhancement programs in Canada. Canadian Medical Association Journal, 153, 1723–1728.
32.
PearsonS.A.RolfeI.E.HenryR.L. (1998). The relationship between assessment measures at Newcastle Medical School (Australia) and performance during internship. Medical Education, 32, 40–45.
33.
PolatajkoH.J.LeeL.H.BossersA.M. (1994). Performance evaluation of occupational therapy students: A reliability study. Canadian Journal of Occupational Therapy, 61, 20–27.
34.
SalvatoriP. (1996). Clinical competence: A review of the health care literature with a focus on occupational therapy. Canadian Journal of Occupational Therapy, 63, 260–71.
35.
StratfordP.W.ThompsonM.A.SanfordJ.SaarinenH.DilworthP.SolomonP.NixonP.Fraser-McDougallV.Pierce-FennH. (1990). Effect of station examination item sampling on generalizability of student performance. Physical Therapy, 1, 31–36.
36.
StreinerD.L.NormanG.R. (1989). Health measurement scales: A practical guide to their development and use. New York: Oxford University Press.
37.
SwansonD.B. (1987). A measurement framework for performance-based tests. In HartI.HardenR. (Eds.), Further Developments in Assessing Clinical Competence (pp. 13–45). Montreal, Qc: Can-Heal.
38.
SwansonD.B.NormanG.R.LinnR.L. (1995). Performance-based assessment: Lessons for the health professions, Educational Researcher, 24(5), 5–11, 35. (Also published in condensed form in Pedagogue, 6(3), 1–7, 1996, available from the Program for Educational Development in the Faculty of Health Sciences at McMaster University in Hamilton, Ontario).
39.
TugwellP.DokC. (1985). Medical record review. In NuefeldV.R.NormanG.R. (Eds.), Assessing clinical competence (pp. 142–182). New York: Springer Publishing.
40.
van der VleutenC.P.M.SwansonD.B. (1990). Assessment of clinical skills with standardized patients: State of the art. Teaching and Learning in Medicine, 2, 58–76.
41.
WuL.AshtonC.M. (1997). Chart review: A need for reappraisal. Evaluation and the Health Professions, 20, 146–163.
