Development of a rating scale to measure learning in clinical dietetics. I. Theoretical considerations and method of construction.

The trend to introduce earlier clinical experience in dietetic education requires that attention be directed toward evaluation of learning of such clinical skills as communication and interpersonal relations. Some of the theoretical factors associated with clinical evaluation are discussed, and a method is described for developing a rating scale to measure learning in an intoductory clinical course in dietetics. The method involved: (a) analysis of course objectives to determine the general areas of learning which were appropriate and valid to measure in the clinical environment; (b) specification of observable and one-dimensional behaviors seen as componets of the overall objectives; and (c) concise definition of the rating continuum. Specific attention was directed toward constructing an instrument which could be used to counsel students as well as provide information for determining grades. Preliminary trials indicated the instrument to be practical, reliable, objective, and valid to measure clinical learning.

Development of a rating scale to measure learning in clinical dietetics. II. Pilot test.

When the instrument was pilot tested under actual conditions of a clinical course, it was found practical to use, provided the raters were sufficiently trained and were aware of the logistical problems that might occur. A consensus of both students and raters reaffirmed that the formative properties of the instrument were of value in student counseling, and the rating of students during each clinical session should continue. The objectivity of the instrument also appeared to be sufficient to allow summative grading of students without large differences of opinion within pairs of raters. Measurement of intra-rater reliability was not attempted. The investigators feel that any future study with the instrument should include this analysis. The process of construction and testing reported here appears to be useful in developing a rating scale to measure learning in clinical dietetics.