The use of interactive video client simulation scores to predict clinical performance of occupational therapy students.

Objective: Student academic performance (grades) has traditionally shown a weak correlation with clinical performance (supervisor ratings). A computer-based interactive video client evaluation program was created to determine whether the decision making of occupational therapy students on a client simulation explained variability in fieldwork supervisor ratings not accounted for by grades.

Method: Two student cohorts (N = 43; N = 30) selected evaluation procedures for a client with a cerebrovascular accident from on-screen menus and recorded and interpreted client responses as shown on videodisc. Multiple regressions were calculated in which grades and simulation scores were used to predict fieldwork supervisor ratings.

Results: In cohort 1, grade in a physical disabilities course predicted 31% of the variance in supervisor ratings, whereas the simulation score for "completeness" accounted for an additional 12%, F(2, 39) = 16.75, p< .0001, adjusted R2= .434. Students with better grades received higher ratings, whereas students who evaluated the simulated client less exhaustively received higher ratings. For cohort 2, fieldwork ratings were best predicted by a combination of several simulation efficiency scores (number of correct answers given per unit time), F(4, 21) = 6.17, p < .002, adjusted R2 = .453. Mostly, higher efficiency scores were associated with higher supervisor ratings.

Conclusion: Video simulations of client encounters may measure decision-making skills not measured by grades, in particular, making correct decisions in a timely manner within a realistic context.