Development of a competency assessment system for clinical reasoningthrough self-reflection in the community pharmacy practice of 6th-year pharmacy students

Abstract

This study aimed to develop the rubric system for assessment of clinical reasoning competency in community pharmacy practice through self-reflection of 6th-year pharmacy students. There were 3 phases of this study with different research methodology. The first phase was focus group discussion of experts to identify components of the competency. The item-objective congruence (IOC) index and the expert discussion were used to judge the content validity of the identified components. In the second phase, the identified components were transformed into a rubric. The rubric was tested for its intra-rater reliability and revised. In the third phase, the inter-rater reliability, and concurrent validity were tested, using the intraclass correlation coefficient (ICC) and the Spearman's correlation coefficient, respectively. The instruction for the self-reflection and SOAP note was also revised in the second phase according to the survey of the student opinions.

Nine components of clinical reasoning competency were identified. Each construct was transformed into a rubric item with 4 competency levels. The content validity of the rubric was substantially high (IOC of rubric items were between 0.88 to 1). The ICCs for intra-rater reliability of each rubric item were from 0.76 to 0.92, which were considered almost perfectly reliable. The ICCs for inter-rater reliability of each rubric item were from 0.52 to 0.69, which were moderately to substantially reliable. However, the assessment scores given by the rubric were not statistically correlated with the scores of SOAP presentation that was the current assessment method (the correlation coefficient = -0.176, p = 0.26). In conclusion, the validated rubric system for assessment of clinical reasoning competency in community pharmacy practice through self-reflection was developed. This rubric was shown to have good reliability and content validity, but limited concurrent validity.