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Judging clinical competence using structured observation tools: A cautionary tale

Roth, AD; Myles-Hooton, P; Branson, A; (2019) Judging clinical competence using structured observation tools: A cautionary tale. Behavioural and Cognitive Psychotherapy 10.1017/S1352465819000316. (In press). Green open access

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Abstract

BACKGROUND: One method for appraising the competence with which psychological therapy is delivered is to use a structured assessment tool that rates audio or video recordings of therapist performance against a standard set of criteria. AIMS: The present study examines the inter-rater reliability of a well-established instrument (the Cognitive Therapy Scale - Revised) and a newly developed scale for assessing competence in CBT. METHOD: Six experienced raters working independently and blind to each other's ratings rated 25 video recordings of therapy being undertaken by CBT therapists in training. RESULTS: Inter-rater reliability was found to be low on both instruments. CONCLUSIONS: It is argued that the results represent a realistic appraisal of the accuracy of rating scales, and that the figures often cited for inter-rater reliability are unlikely to be generalizable outside the specific context in which they were achieved. The findings raise concerns about the use of these scales for making summative judgements of clinical competence in both educational and research contexts.

Type: Article
Title: Judging clinical competence using structured observation tools: A cautionary tale
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1017/S1352465819000316
Publisher version: https://doi.org/10.1017/S1352465819000316
Language: English
Additional information: This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: assessment, clinical supervision, therapist competence, training
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: http://discovery.ucl.ac.uk/id/eprint/10075123
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