Principles of Assessment and Outcome Measurement for Occupational Therapists and Physiotherapists: Theory, Skills and Application
Occupational Therapy and Physiotherapy.
Labels used for providers and recipients of therapy services.
The importance of the selection and application of terminology in practice.
Definitions of key terms.
Summary of definitions..
Chapter 1: The importance of accurate assessment and outcome measurement (Alison Laver Fawcett, PhD, DipCOT).
Assessment as a core part of the therapy process.
The impact of health and social care policy on assessment practice.
The demand for evidenced-based practice.
Levels of evidence and grades of recommendations.
The application of standardised assessments.
The use of standardised versus non-standardised assessments.
Benefits of applying standardised measures.
The requirement to demonstrate effectiveness.
A focus on client-centred practice.
The demand for robust clinical governance.
The use of standards, protocols, guidelines and care pathways.
The complexity of assessment.
The nature of therapeutic practice.
The nature of human occupation and occupational performance.
The nature of human function and the complexity of measuring functional outcomes.
The influence of the level of task demand.
The impact of familiarity on performance.
The influence of environment upon performance.
The constraints of the practice setting.
The Big Question.
Chapter 2: Methods of assessment and sources of assessment data(Alison Laver Fawcett, PhD, DipCOT, Sally Payne, MSc, BSc, DipCOT and Claire Howell, BScOT (Hons)).
Methods of data collection.
Sources of Assessment Information.
Interviewing as a means of collecting self-report data.
Communication, insight and capacity issues.
Cultural issues and self-report data collection.
Examples of self-report assessments.
Examples of assessments that use information from a proxy.
Measures that assess the proxy (e.g. Care-giver and parent burden scales).
Observational assessment methods.
Examples of observational assessment.
Examples of how therapists combine different assessment methods.
Case Study: Scott, by Sally Payne and Claire Howell.
Reflecting on the data collection methods you use in your practice.
Chapter 3: Purposes of assessment and measurement (Alison Laver Fawcett, PhD, DipCOT and Karen Innes, BSc OT, DMS, Cert Counselling).
Timing of assessment in the therapy process.
Ongoing evaluative assessment.
Purposes of assessment.
Assessment for particular purposes.
Assessment for tribunals.
Needs assessment - considering wider populations.
Sharing your purpose.
Case vignette: Mr Smith.
Beginning a service evaluation.
Case study: service evaluation - The Development and initial evaluation of a Memory Activity and Self Help (MASH) Group by Karen Innes and Alison Laver Fawcett.
Reflecting on purposes of assessment in your own practice.
Chapter 4: Levels of measurement (Alison Laver Fawcett, PhD, DipCOT).
What is measurement?
The assignment of numbers for the purposes of assessment.
What are levels of measurement?
Application of different levels of measurement - issues to consider.
Applying concepts of levels of measurement to your own practice.
Chapter 5: Standardisation and test development (Alison Laver Fawcett, PhD, DipCOT).
Why should therapists use standardised tests?
What is a standardised test?
What is an un-standardised assessment?
Test construction decisions.
Criteria for judging norms.
Training and interpreting standardised test scores.
Chapter 6: Validity and clinical utility (Alison Laver Fawcett, PhD, DipCOT).
Definition of validity.
Other types of validity.
Definition of Ecological validity.
Definition of External validity.
Establishing the overall validity of a test .
Energy and effort.
Examining validity and clinical utility issues: test examples.
Applying concepts of validity to your own practice.
Chapter 7: Reliability (Alison Laver Fawcett, PhD, DipCOT.)
Introducing the concept of reliability.
Reliability coefficients and standard error of measurement.
Level of significance.
Error of measurement.
Standard error of measurement (SEM).
Types of reliability.
Parallel form reliability (equivalent or alternate form).
Floor and ceiling effects.
The statistic used to calculate the level of reliability can impact the results.
Percentage agreement (P).
Intra class correlation coefficients (ICC).
Pearson product-moment correlation coefficient.
Cohen's Kappa (K).
Comparing statistical methods for evaluating reliability.
Examining reliability data: test examples.
Applying concepts of reliability to your own practice.
Chapter 8: Test administration, reporting and recording (Alison Laver Fawcett, PhD, DipCOT and Rachael Hargreaves, BSc(Hons) SROT).
Steps in the Test Administration Process.
Step 1: Preparation for testing.
Gaining consent to assess.
Organising the environment.
Preparing tools, materials and equipment.
Timing your assessment.
Step 2: Test administration.
Using standardised tests.
Following standardised procedures.
Use of prompting and cues.
Step 3: Scoring.
Step 4: Analysis of scores.
Step 5: Interpreting test scores.
Step 6: Decision making in light of the interpretation of test scores.
Step 7: Client feedback about the test results and implications.
Step 8: Recording and reporting results.
Headings for writing a report on a standardised test administration.
Electronic care records.
Case example: James’ Assessment of Motor and Process Skills (AMPS) report by Rachel Hargreaves.
Chapter 9: Applying models of function to therapy assessment and measurement (Alison Laver Fawcett, PhD DipCOT and David Jelley).
Why use models?
The complexity of human function.
General systems theory and the hierarchy of living systems.
International Classification of Impairment, Disability and Handicap.
Wade’s (1988) 4-level model for people with stroke.
Five Level Model of Function and Dysfunction.
Description of the NCMRR five levels of Function / Dysfunction.
International Classification of Functioning, Disability and Health (ICF).
Applying the ICF to therapy assessment.
‘Top-down’ versus ‘bottom-up’ assessment approach.
Case Study: Mary, by David Jelly and Alison Laver Fawcett.
Chapter 10: The importance of clinical reasoning and reflective practice in effective assessment (Alison Laver Fawcett, PhD, DipCOT and Karen Innes, BSc OT, DMS, Cert Counselling).
Clinical reasoning as an essential component of practice.
Clinical judgement and clinical reasoning.
Diagnostic reasoning and the therapy diagnosis.
Problem-orientated clinical reasoning process.
Framing the problem.
Delineating the problem.
Pattern recognition, hypotheses and heuristics.
Other forms of reasoning.
Client / Therapist stories.
Prospective treatment story.
Therapists sharing stories.
Ethical reasoning / moral reasoning.
Reflective practice as a component of continuing professional development.
Novice to Expert continuum.
Case study: Mrs Ellis’ Initial Assessment Process by Karen Innes and Alison Laver Fawcett.
Chapter 11:Implementing the optimum assessment and measurement approach (Alison Laver Fawcett, PhD, DipCOT).
Improving assessment and measurement practice: where to begin?
Analysing your current assessment practice.
Mapping your current assessment and measurement process.
Improving your assessment process.
PDSA cycle approach.
Exploring the literature for examples of tests and test critiques.
Example reviews and critiques in books.
Example reviews and critiques in journal articles.
Questions for undertaking a Test Critique.
An example Test Critique: The Parenting Stress Index (PSI).
Obtaining permission to use a test for your clinical practice or for research.
Modifying a standardised test.
Linking improving your assessment practice to continuing professional development.
Assessment and outcome measurement goals for effective practice.
Conclusion: achieving an effective and efficient assessment.
Study questions and tasks.
Chapter 12: The Final Case Study: ‘Carol’ experience of a Chronic Pain Service (Alison Laver Fawcett, PhD DipCOT, Gail Brooke, Dip Phys, Cert in Health Service management, and Heather Shaw, DipCOT).
Introduction to the therapists and the Chronic Pain service.
The Chronic Pain Service.
Standardised measures used in the service.
Introduction to the Case ‘Carol’.
Multi-disciplinary team (MDT) half-day clinic assessment process.
Occupational therapy assessment.
Description of the therapy diagnosis / problem.
Multi-disciplinary team meeting with Carol.
Summary of the results other team members’ assessments.
Carol’s Individual Treatment Plans: Occupational Therapy.
Carol’s Individual Treatment Plans: Physiotherapy.
Individual treatment sessions with the physiotherapist.
Individual treatment sessions with the occupational therapist.
The Group intervention programme: Turnabout.
Carol’s Completion Story.
Carol’s Goal Planning.
Outcome measurement and discharge.
First follow-up evaluation.
Six month follow-up evaluation.
Carol’s COPM change scores.
Brief answers to study questions.
"...this is one book that I bought for myself as soon as it was published." (British Journal of Occupational Therapy, February 2008)
"This is a useful textbook for occupational therapists and physiotherapists or those studying to become one." (Occupational Health, March 2008)
- Assessment is a key component of the curriculum in both OT and physiotherapy undergraduate training
- Embodies current thinking on a shift towards standardized assessment as well as client-centred practice
- Evaluates methods of test critique using case studies and provides sources for published tests
- Reviews models of function (eg National Council for Medical Rehabilitation 5 level model, WHO ICDIH-2 International Classification of Impairments)