How to Make a Test Form
Have you ever wanted a test form to be in your file drawer for an item being assessed? Not a form located at home in a book or in an article. Would you like a freestanding form for documenting test data versus a scrap of paper that must be rewritten?
Well, our program set out on a mission to develop a file of test forms. I was in charge of this for myself and four co-workers. Sharing this experience will hopefully guide you through the process.
One of your first choices will be to decide how much time do you want to spend on completing a form. Do you want to use a narrative or a number and letter format? Can the test correctly be performed? Can the results be compared between testers? Does this test have a ceiling limit? For example, did the individual perform a sit to standing transfer because they achieved normal hip strength or because they achieved the amount of strength it takes to complete this task.
Our decision was to use numeric or assigned letter values. These items are objective and can later be easily compared. Test with a letter or numeric keys need to have measurable, nonambiguous assigned definitions for each key value.
A timed value is surprisingly the quickest way to test and record. You need to ensure that there is a procedure for when the timing starts and stops, so that everyone is measuring the same interval.
Timed and numeric values allow for totaling a score in a skill area. Be careful when collectively scoring as it may not accurately reflect the results of the individual items.
Why Reinvent the Wheel? Access to Existing Resources:
You are probably thinking where are you going to get the time to create a form, verify its validity, write the policy and procedure and make copies of the form. The Functional Tool Box by C.B. Lewis and T. McNerney from Learn Publications and are available text resources.
The difficulty is in acquiring permission to photocopy the forms from the text. You will need the addresses or the phone numbers of the publishing companies. They can help to provide a contact to the owner of the material. There can be a nominal fee for permission to copy.
In a case where the text itself copyrighted from multiple citations, such as the "Tool Box", it becomes an insurmountable task. The publisher got the names and addresses for the cited, copyrighted material prior to the complete text going to print. This is well before the book ever got into your hands and well before your request for permission to copy. Addresses often change, the publishers do not have the staffing to continually track where all the owners are and the next publication project has their attention.
If thwarted by such a process, contact your internal legal department for assistance with copy right information. You can ask leaders in the field about which forms, if any, are the Apublic domains@ so as to copy.
A written procedure is recommended on any instrument intended for use. This lends to improve inter- and intra-rater reliability. Procedural process helps to improve quality of care and meet standards of accreditation. Information from a literature search can support the test procedure and inform you and you colleagues about the test ramifications.
The traditional library search is still effective. Our students and families with access to the various universities and the willingness to help were great resources. Together we made substantial progress in getting the articles that supported existing test forms. This method is economical at ten cents a page to photocopy an article. There are services which can do this for you with higher cost of $3.00 or more per page.
Use of the Internet will help to acquire abstracts and listed related information. However, the entire citation content is not available.
The hot topic for the 90's is falls in the elderly. There are multiple tests available on balance. However, as physical therapists we examine more than a singular component.
Are you aware there are test scales for tone and gait? Functional performance tests and ataxia batteries exist. The list goes on and on, including range of motion, manual muscle tests, posture, etc., etc.
Each test is a part of a whole. I recommend that you have a mix of test tools so as to have a balanced assessment. Examine several areas of significance to the total function.
The use of scientifically, based tools can greatly enhance our profession. The collection of valid data at the point of the initial patient exam can only lend credence to what we do, to our patients, to our outcomes and to our payers.
Drawbacks:
I did encounter difficulties that are readily apparent with the tests.
Our profession as a collective does not have standardized tests. This was quite surprising when compared with other clinical departments. As significant leaders in the rehabilitation process I do not know how we gained our importance without it. This is a risk challenge to the efficacy of our treatments. A strong research effort into standardized testing is indicated in the twenty-first century.
There is also a lack of normative values for the disabled and the able populations. In a specific category for testing there is a lack of skill range. Our patients range from the very immobile individual to the competitive athlete. Tests in the future may need to consider a continuum, perhaps based on a functional recovery model or progression of life skills.
Many tests examine neuromusculoskeletal components. Neurologically based tests examine the affected versus unaffected limb. What do you do if both limbs are affected? There is a lack of integration of the cognitive, visual, vestibular and the multiple domains that impact on motor skills which are not reflected on the forms. It leaves one to wonder AI think, therefore I move@ or AI move, therefore I think.@
The Process Goes On:
The next time you reach into the file drawer, a test form will be there. Something easy to use, easy to repeat and measured what you wanted.
This was a rewarding experience. It clinically allowed me to stretch my expertise and exercise many brain cells.
Our form file process is still ongoing. I could have gone about it differently or changed the depth. There must be multiple ways to do this. What do you think? What have you done at your own facility? Care to share your thoughts? Please contact me:
Carol Straiton, P.T. Or:
Beechwood Rehab Services 837 Harris Ave
469 East Maple Ave. Croydon, PA 19021
Langhorne, PA 19047 E-mail PTNEY@VOICENET.COM
(215) 750-4304
FAX (215) 750-4327