Article

Objective: To test whether clinician expertise and FIM(TM) instrument rating difficulty explain clinician overconfidence in FIM rating accuracy. Design: Participants answered 60 true/false FIM questions and, for each question. Completed a 6-category scale to assess confidence in the accuracy of their responses. Experts and novices, as well as hard and easy items, Were identified through a Rasch analysis, The relation between confidence and accuracy was examined for these different groups. Setting: Three urban medical centers. Participants: Fifty medical rehabilitation professionals, including physical therapists, occupational therapists, rehabilitation psychologists, speech pathologists, and rehabilitation nurses. Interventions: Not applicable. Main Outcome Measures: Observed proportion of correct responses to 60 true/false questions and responses from the 6-category confidence scale. Results: The amount of overconfidence was mediated by the difficulty of the FIM task and the level of expertise of the clinical,judge. Conclusions: Decreasing the level of overconfidence in FIM scoring is a promising avenue for improving the accuracy of functional assessment. Accurate assessment of functional status for case-mix group classification will be of even greater importance under the recently initiated Medicare prospective payment system.

Langue : ANGLAIS

Identifiant basis : 2003226394