scholarly journals Assessing Professional Students' Application of the International Classification of Functioning, Health, and Disability Model and Patient-Reported Outcome Measures During Patient Care

2021 ◽  
Vol 16 (4) ◽  
pp. 316-320
Author(s):  
Sara L. Nottingham

Context The International Classification of Functioning, Health, and Disability (ICF) model and patient-reported outcome measures (PROMs) are concepts that must be addressed in professional education. Objective Describe a class assignment that allows students to integrate the concepts of the ICF model and PROMs into actual patient care. Background Adult learners, including professional athletic training students, thrive on learning experiences where they can apply concepts and integrate new knowledge with existing knowledge. In addition, existing research suggests that most athletic trainers are not integrating PROMs into their clinical practice; therefore, students are most likely not seeing the use of PROMs during clinical education. Faculty can facilitate the application of the ICF model and PROMs into patient care with a course-based assignment. Description The assignment requires students to use the ICF model as an assessment tool with an actual patient, which helps shape their therapeutic interventions. Students recorded baseline and follow-up PROMs with this patient over a time period of at least 3 weeks while documenting their interventions and the patient's change over time. Students addressed reflection prompts in the assignment by describing their successes and challenges, in addition to describing their future plans for integrating the ICF model and PROMs into their clinical practice. Clinical Advantage(s) Students described this assignment as beneficial because it helped them treat their patients more holistically. Students self-reported increased knowledge and confidence with using the ICF model and PROMs in their clinical practice. Students described a plan to integrate these concepts into their clinical practice in a limited fashion. Conclusion(s) Faculty may consider integrating an applied, patient-based assignment such as this to assess students' application of the ICF model and PROMs to an actual patient. This assignment can also be easily condensed or expanded to fit different courses, student background knowledge, and assessment of different curricular content standards.

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Derek Rosa ◽  
Joy MacDermid ◽  
Dorota Klubowicz

Abstract Background Standardized coding of the content presented in patient reported outcome measures can be achieved using classification frameworks, and the resulting data can be used for ascertaining content validity or comparative analyses. The International Classification of Functioning (ICF) is a framework with a detailed conceptual structure that has been successfully utilized for such purposes through established coding procedures. The Item Perspective Classification (IPC) framework is a newly developed relational coding system that classifies the respondent perspective and conceptual domains addressed in items. The purpose of this study was to compare and describe the performance of these two frameworks when used alone, and in conjunction, for the generation of data pertaining to the content of patient reported outcome measures. Methods Six health-related quality of life questionnaires with a total of 159 items were classified by two raters using the Item Perspective Classification framework in conjunction with the International Classification of Functioning. Framework performance indicators included: classification capacity (percent of items amenable to successful classification), coding efficiency (number of codes required to classify items), and content overlap detection (percent of items sharing identical classification codes with at least one other item). Inter-rater reliability of item coding was determined using Krippendorff's alpha. Results Classification capacity of the IPC framework was 97%, coding efficiency 26, and content overlap detection was 95%; whereas respective values for the ICF were 68%, 114, and 58%. When used in conjunction values were 63%, 129, and 30%. Krippendorff's alpha exceeded 0.97 for all 3 classification indices. Conclusion Inter-rater agreement on classification data was excellent. The IPC framework provided a unique classification of the respondent’s judgment during item response and classified more items using fewer categories, indicated greater content overlap across items and was able to describe the relationship between multiple concepts presented within the context of a single item. The ICF provided a unique classification of item content relating to aspects of disability and generated more detailed and precise descriptions. A combined approach provided a rich description (detailed codes) with each framework providing complementary information. The benefits of this approach in instrument development and content validation require further investigation.


2020 ◽  
Vol 5 (2_suppl) ◽  
pp. 48-60
Author(s):  
Lesley Ann Saketkoo ◽  
Mary Beth Scholand ◽  
Matthew R. Lammi ◽  
Anne-Marie Russell

Systemic sclerosis (SSc) is a progressive vasculopathic, fibrosing autoimmune condition, portending significant mortality; wherein interstitial lung disease (ILD) is the leading cause of death. Although lacking a definitive cure, therapeutics for (SSc-ILD) that stave progression exist with further promising primary and adjuvant compounds in development, as well as interventions to reduce symptom burden and increase quality of life. To date, there has been a significant but varied history related to systemic sclerosis–related interstitial lung disease trial design and endpoint designation. This is especially true of endpoints measuring patient-reported perceptions of efficacy and tolerability. This article describes the underpinnings and complexity of the science, methodology, and current state of patient-reported outcome measures used in (SSc-ILD) systemic sclerosis–related interstitial lung disease in clinical practice and trials.


2016 ◽  
Vol 26 (2) ◽  
pp. 245-257 ◽  
Author(s):  
Michelle M. Holmes ◽  
George Lewith ◽  
David Newell ◽  
Jonathan Field ◽  
Felicity L. Bishop

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243563
Author(s):  
Alexandra O. Robertson ◽  
Valerija Tadić ◽  
Jugnoo S. Rahi

Background/Objectives Routine use of patient-reported outcome measures (PROMs) to assess quality of health care systems is mandated in many countries and has been implemented successfully in many specialities. Ophthalmology currently lags behind. To support and inform future implementation, we investigated paediatric ophthalmic clinicians’ experience of, and future training needs for, using child-appropriate vision PROMs and their views about the barriers and enablers to future routine implementation in clinical practice. Methods We conducted a pilot study, using an online survey to elicit the experience, attitudes, training needs and perceptions of barriers and enablers to routine PROMs use of ophthalmic health professionals in the Paediatric Ophthalmology Department at Great Ormond Street Hospital, London. A focus-group was undertaken to discuss survey results and preferences regarding presentation of PROM data. Analysis comprised descriptive statistics, presented alongside complementary qualitative data. Results Eighteen clinicians in the department completed the survey. Twenty-seven took part in the focus group. Clinicians had limited experience of using PROMs but high confidence in the potential positive impact on communication with patients, monitoring chronic conditions and clinical decision-making. Clinicians identified operational issues (collection and analysis of data) and impact (interpretation and application of data) as the two key areas for consideration. Training and information requirements before implementation were clearly articulated, alongside the benefits of using digital/electronic data capture ahead of consultations to allow efficiency and automated analysis, and presentation in an appropriate visual format alongside clinical data to ensure meaningful use. Conclusion The findings of this pilot study of ophthalmic clinicians working in a specialist paediatric ophthalmology department, suggest that ophthalmic clinicians recognise the potential benefits of routine PROMs use in clinical practice. Together with existing literature outside ophthalmology relating to overcoming barriers and exploiting enablers to routine implementation, findings may be applicable in planning routine PROM implementation in paediatric ophthalmology.


2017 ◽  
Vol 5 (2) ◽  
pp. 1-280 ◽  
Author(s):  
Joanne Greenhalgh ◽  
Sonia Dalkin ◽  
Kate Gooding ◽  
Elizabeth Gibbons ◽  
Judy Wright ◽  
...  

BackgroundThe feedback of patient-reported outcome measures (PROMs) data is intended to support the care of individual patients and to act as a quality improvement (QI) strategy.ObjectivesTo (1) identify the ideas and assumptions underlying how individual and aggregated PROMs data are intended to improve patient care, and (2) review the evidence to examine the circumstances in which and processes through which PROMs feedback improves patient care.DesignTwo separate but related realist syntheses: (1) feedback of aggregate PROMs and performance data to improve patient care, and (2) feedback of individual PROMs data to improve patient care.InterventionsAggregate – feedback and public reporting of PROMs, patient experience data and performance data to hospital providers and primary care organisations. Individual – feedback of PROMs in oncology, palliative care and the care of people with mental health problems in primary and secondary care settings.Main outcome measuresAggregate – providers’ responses, attitudes and experiences of using PROMs and performance data to improve patient care. Individual – providers’ and patients’ experiences of using PROMs data to raise issues with clinicians, change clinicians’ communication practices, change patient management and improve patient well-being.Data sourcesSearches of electronic databases and forwards and backwards citation tracking.Review methodsRealist synthesis to identify, test and refine programme theories about when, how and why PROMs feedback leads to improvements in patient care.ResultsProviders were more likely to take steps to improve patient care in response to the feedback and public reporting of aggregate PROMs and performance data if they perceived that these data were credible, were aimed at improving patient care, and were timely and provided a clear indication of the source of the problem. However, implementing substantial and sustainable improvement to patient care required system-wide approaches. In the care of individual patients, PROMs function more as a tool to support patients in raising issues with clinicians than they do in substantially changing clinicians’ communication practices with patients. Patients valued both standardised and individualised PROMs as a tool to raise issues, but thought is required as to which patients may benefit and which may not. In settings such as palliative care and psychotherapy, clinicians viewed individualised PROMs as useful to build rapport and support the therapeutic process. PROMs feedback did not substantially shift clinicians’ communication practices or focus discussion on psychosocial issues; this required a shift in clinicians’ perceptions of their remit.Strengths and limitationsThere was a paucity of research examining the feedback of aggregate PROMs data to providers, and we drew on evidence from interventions with similar programme theories (other forms of performance data) to test our theories.ConclusionsPROMs data act as ‘tin openers’ rather than ‘dials’. Providers need more support and guidance on how to collect their own internal data, how to rule out alternative explanations for their outlier status and how to explore the possible causes of their outlier status. There is also tension between PROMs as a QI strategy versus their use in the care of individual patients; PROMs that clinicians find useful in assessing patients, such as individualised measures, are not useful as indicators of service quality.Future workFuture research should (1) explore how differently performing providers have responded to aggregate PROMs feedback, and how organisations have collected PROMs data both for individual patient care and to improve service quality; and (2) explore whether or not and how incorporating PROMs into patients’ electronic records allows multiple different clinicians to receive PROMs feedback, discuss it with patients and act on the data to improve patient care.Study registrationThis study is registered as PROSPERO CRD42013005938.FundingThe National Institute for Health Research Health Services and Delivery Research programme.


Sign in / Sign up

Export Citation Format

Share Document