Assessing Therapist Competence: Development of a Performance-Based Measure and Its Comparison With a Web-Based Measure
Assessing Therapist Competence: Development of a Performance-Based Measure and Its Comparison With a Web-Based Measure
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DOI：
10.2196/mental.7704
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发表时间：
2017-10-01
影响因子：
5.2
通讯作者：
Fairburn, Christopher G.
中科院分区：
文献类型：
--
作者：
Cooper, Zafra;Doll, Helen;Fairburn, Christopher G.
背景资料：最近的研究兴趣，如何最好地培训治疗师提供心理治疗，强调了需要严格的，但可扩展的，治疗师能力的测量手段。评估治疗师的能力至少有两个组成部分：评估他们对有关治疗的知识，包括如何以及何时使用其策略和程序，以及评估他们在实践中熟练应用这些知识的能力。虽然对治疗师知识的评估有可能在网络上高效完成，但对技能的评估通常涉及临床医生进行的劳动密集型过程，因此，在某些情况下可能不适合评估培训结果。目标：本研究的目的是开发和评估一个角色扮演-基于技能的措施，适合评估培训成果，并比较其性能与一个高度可扩展的基于Web的应用知识的措施。以进食障碍的强化认知行为疗法（CBT-E）为例，开发了角色扮演评估的临床场景，并与评估实习治疗师表现的评级计划一起进行了试点。这些方案进行了评估，通过检查93个治疗师的表现，从不同的专业背景和不同层次的培训，在实施CBT-E。这些治疗师还完成了以前开发的基于网络的措施的应用知识，和能力的基于网络的措施，有效地预测能力的角色扮演measurement.Results：角色扮演措施评估性能在实施一系列的CBT-E程序。大多数治疗师认为他们的表现与他们通常的临床表现中等或非常相似。经过培训的评分员能够实现良好到优秀的平均能力的可靠性，组内相关系数范围从0.653到909。该指标对变化也很敏感，训练后的得分明显高于训练前（平均差异为0.758，P
Background: Recent research interest in how best to train therapists to deliver psychological treatments has highlighted the need for rigorous, but scalable, means of measuring therapist competence. There are at least two components involved in assessing therapist competence: the assessment of their knowledge of the treatment concerned, including how and when to use its strategies and procedures, and an evaluation of their ability to apply such knowledge skillfully in practice. While the assessment of therapists' knowledge has the potential to be completed efficiently on the Web, the assessment of skill has generally involved a labor-intensive process carried out by clinicians, and as such, may not be suitable for assessing training outcome in certain circumstances.Objectives: The aims of this study were to develop and evaluate a role-play-based measure of skill suitable for assessing training outcome and to compare its performance with a highly scalable Web-based measure of applied knowledge.Methods: Using enhanced cognitive behavioral therapy (CBT-E) for eating disorders as an exemplar, clinical scenarios for role-play assessment were developed and piloted together with a rating scheme for assessing trainee therapists' performance. These scenarios were evaluated by examining the performance of 93 therapists from different professional backgrounds and at different levels of training in implementing CBT-E. These therapists also completed a previously developed Web-based measure of applied knowledge, and the ability of the Web-based measure to efficiently predict competence on the role-play measure was investigated.Results: The role-play measure assessed performance at implementing a range of CBT-E procedures. The majority of the therapists rated their performance as moderately or closely resembling their usual clinical performance. Trained raters were able to achieve good-to-excellent reliability for averaged competence, with intraclass correlation coefficients ranging from.653 to 909. The measure was also sensitive to change, with scores being significantly higher after training than before as might be expected (mean difference 0.758, P