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Validation of MSAT: An instrument to measure medical students' self-assessed confidence in musculoskeletal examination skills

Lookup NU author(s): Dr David Coady, Dr David Walker, Dr Lesley Kay, Dr Iftikhar Haq


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Context: Self-assessment promotes reflective practice, helps students identify gaps in their learning and is used in curricular evaluations. Currently, there is a dearth of validated self-assessment tools in rheumatology. We present a new musculoskeletal self-assessment tool (MSAT) that allows students to assess their confidence in their skills in and knowledge of knee and shoulder examination. Objectives: We aimed to validate the 15-item MSAT, addressing its construct validity, internal consistency, responsiveness, repeatability and relationship with competence. Methods: Participants were 241 Year 3 students in Newcastle upon Tyne and 113 Year 3 students at University College London, who were starting their musculoskeletal skills placement. Factor analysis explored the construct validity of the MSAT; Cronbach's α assessed its internal consistency; standardised response mean (SRM) evaluated its responsiveness, and test-retest, before and after a pathology lecture, assessed its repeatability. Its relationship with competence was explored by evaluating its correlation with shoulder and knee objective structured clinical examinations (OSCEs). Results: The MSAT was valid in distinguishing the 5 domains it intended to measure: clinical examination of the knee; clinical examination of the shoulder; clinical anatomy of the knee and shoulder; history taking, and generic musculoskeletal anatomical and clinical terms. It was internally consistent (α = 0.93), responsive (SRM 0.6 in Newcastle and 2.2 in London) and repeatable (intraclass correlation coefficient 0.97). Correlations between MSAT scores and OSCE scores were weak (r < 0.2). Conclusions: The MSAT has strong psychometric properties, thereby offering a valid approach to evaluating the self-assessment of confidence in examination skills by students. Confidence does not necessarily reflect competence; future research should clarify what underpins confidence. © 2007 Blackwell Publishing Ltd.

Publication metadata

Author(s): Vivekananda-Schmidt P, Lewis M, Hassell AB, Coady D, Walker D, Kay L, McLean MJ, Haq I, Rahman A

Publication type: Article

Publication status: Published

Journal: Medical Education

Year: 2007

Volume: 41

Issue: 4

Pages: 402-410

ISSN (print): 0308-0110

ISSN (electronic): 1365-2923

Publisher: Wiley-Blackwell Publishing Ltd.


DOI: 10.1111/j.1365-2929.2007.02712.x

PubMed id: 17430286


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