Issues in Selecting Methods of Evaluating Clinical Competence in the Health Professions: Implications for Athletic Training Education

Objectives: To examine methods used to evaluate the clinical competence and proficiency of students in medicine and allied health professions. To identify factors that would be valuable to educators in athletic training and other medical and allied health professions in the development and use of clinical assessment methods.

Data Sources: We searched EBSCO Academic, InfoTrac, MEDLINE and PubMed for literature from professional journals related to clinical education, assessing clinical competence, clinical competence, clinical proficiency assessment.

Data Synthesis: Assessment of competence in the clinical setting is an issue for medicine and allied health education programs, including athletic training. Methods used to assess clinical competence included written, objective tests, checklists, oral examinations, patient management problems, simulated patients, observed clinical situations, the Observed Structured Clinical Exam and observation of students. Each method has its advantages and concerns. Psychometric issues relating to reliability, validity and generalizability arise in the development and implementation of clinical assessment instruments. In addition, there are concerns about how faculty expectations relate to student performance and how novices perform in the clinical setting as compared to experienced practitioners.

Conclusions/Recommendations: Although specific outcomes may differ between the medical and allied health professions, athletic training educators can benefit from the lessons learned about methods used to evaluate students in the clinical setting. In an effort to capitalize on the benefits and minimize the problems with the assessment of clinical competence and proficiency, athletic training educators must be aware of the psychometric and outcome-related issues in test development. Attention should be paid to issues of reliability, validity and generalizability when developing tests. Clinical education outcomes must be developed in a manner that addresses the variety of cognitive levels at which clinicians function in professional practice to develop authentic assessments of clinical proficiency.