Developing a valid and reliable tool to assess competence in fabricating custom hand orthoses: self versus expert assessment

Occupational therapists in hand therapy fabricate custom hand othoses in order to maximise upper limb function. Increased importance is being placed on the competency of this technical skill. The purpose of this study was to develop a valid and reliable orthosis competency assessment and use this to investigate the relationship between a student's self rating and an expert assessment. The research followed three stages. In the first stage, an orthosis competency rubric was developed. In the second stage, the inter-rater reliability was tested. In the third stage, students and an expert completed the rubric. The rubric showed acceptable inter-rater reliability (k=0.6). There was a statistically significant difference between the student and expert scores, with students more likely to over-rate their performance. A valid and reliable orthosis competency rubric was designed for use with occupational therapy students in clinical and university settings. It is recommended the rubric be used as an expert-rated tool and for teaching and accurate self-assessment.