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Judging clinical competence using structured observation tools: a cautionary tale

Roth, A., Myles-Hooton, P. and Branson, A. (2019) Judging clinical competence using structured observation tools: a cautionary tale. Behavioural and Cognitive Psychotherapy, 47 (6). pp. 736-744. ISSN 1352-4658

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To link to this item DOI: 10.1017/S1352465819000316


Background: One method for appraising the competence with which psychological therapy is delivered is to use a structured assessment tool that rates audio or video recordings of therapist performance against a standard set of criteria. Aims: The present study examines the inter-rater reliability of a well-established instrument (the Cognitive Therapy Scale – Revised) and a newly developed scale for assessing competence in CBT. Method: Six experienced raters working independently and blind to each other’s ratings rated 25 video recordings of therapy being undertaken by CBT therapists in training. Results: Inter-rater reliability was found to be low on both instruments. Conclusions: It is argued that the results represent a realistic appraisal of the accuracy of rating scales, and that the figures often cited for inter-rater reliability are unlikely to be generalizable outside the specific context in which they were achieved. The findings raise concerns about the use of these scales for making summative judgements of clinical competence in both educational and research contexts.

Item Type:Article
Divisions:Life Sciences > School of Psychology and Clinical Language Sciences > Department of Psychology
ID Code:94876
Publisher:Cambridge University Press


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