Journal of Continuing Education in the Health Professions



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CURRENT ISSUE BACK ISSUES SUBSCRIBE ADVERTISE ABOUT JCEHP FOR AUTHORS JCEHP AWARD SEARCH		Volume 29 (2) Volume 29, Issue 2, Spring 2009 J Contin Educ Health Prof 2009; 29(2):119 ORIGINAL RESEARCH The Adapted Fresno Test of competence in evidence-based practice Annie McCluskey, Bianca Bishop A b s t r a c t Introduction: Health educators who teach professionals about evidence-based practice (EBP) need instruments to measure change in skills and knowledge. This study aimed to develop and evaluate the interrater reliability, internal consistency, and responsiveness of the Adapted Fresno Test (AFT) of competence in EBP. Methods: Reliability testing involved 2 raters. The AFT was completed by 114 occupational therapists before, and 106 therapists after a 2-day workshop on EBP. A random sample of 20 completed tests (10 pre- and 10 postworkshop = Versions 1 and 2) were scored by 2 raters. Interrater reliability was calculated with the use of intraclass correlation coefficients (ICC, 1,2) for 7 summed subtest scores and the total AFT score. Internal consistency was calculated with the use of Cronbach's . Responsiveness was calculated by comparing mean pre–post change scores, change in low scorers with high scorers. Results: Interrater reliability ranged from good to excellent for individual AFT subtests (Version 1: ICC, 0.80-0.96; Version 2: 0.68-0.94), and excellent for total AFT scores (Version 1: ICC, 0.96; Version 2: ICC, 0.91). Internal consistency was acceptable (Cronbach's , 0.74). Overall mean change on the 156-point test was 20.6 points (95% confidence interval [CI], 15.6-25.5), 26.8 points (95% CI, 21.6-1.9) for low scorers and -1.8 points (95% CI, -6.4 to 10.1) for high scorers. Discussion: The AFT has acceptable psychometric properties, and measures change in knowledge and skills of rehabilitation professionals following EBP training. The test is most useful for evaluating change in novice learners. Lessons for Practice The AFT measures change in EBP skills and knowledge, such as the ability to search for and critically appraise research papers. The test is suitable for use by rehabilitation professionals and health educators. The short 7-item AFT has acceptable interrater reliability and internal consistency, and is responsive to change in low-scoring novice learners. The AFT is most useful for demonstrating change in novice learners of EBP, with the test content aimed at this population. Novice learners demonstrated a mean change of 26.8 points on the 156-point AFT scale immediately after a 2-day training workshop on EBP. The AFT takes 20 minutes to complete and 20 minutes to score, and is currently being used by rehabilitation practitioners to measure change in EBP competence following workplace-based training. Future research should concurrently measure EBP skills and knowledge in a control group that receives no education, and further examine test responsiveness and reliability under a wider range of rehabilitation scenarios.Alonger version of theAFT needs to be developed and evaluated, and should include the extra 5 questions from the original Fresno Test based around rehabilitation scenarios, and questions about qualitative research evidence.
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