Reliability and validity of an extended simulated patient case: A tool for evaluation and research in physiotherapy

The purpose of the study was to determine the reliability and validity of a simulated patient to portray a case over time and to evaluate student performance of history taking and physical examination. Twenty four physiotherapy students and four physiotherapists were involved in the study. The subjects were required to carry out a comprehensive history and physical examination of a simulated patient with musculoskeletal (rotator cuff) pathology. Standardised checklists were used to evaluate the performance of the candidates. History taking, physical examination, and interpersonal communication skills were evaluated. The accuracy and rating reliability of the simulated patient was evaluated. The results demonstrate that the simulated patient was able to maintain a high degree of accuracy in his performance. Inter-rater and intra-rater reliability of the simulated patient was maintained at acceptable levels. The outcome of this study demonstrates that extended simulated patient encounters can be used effectively in clinical performance evaluation and research. As a measurement and evaluation tool they appear to possess a high degree of psychometric reliability and validity.