OBJECTIVE. Student academic performance (grades) has traditionally shown a weak correlation with clinical performance (supervisor ratings). A computer-based interactive video client evaluation program was created to determine whether the decision making of occupational therapy students on a client simulation explained variability in fieldwork supervisor ratings not accounted for by grades.
METHOD. Two student cohorts (N = 43; N = 30) selected evaluation procedures for a client with a cerebrovascular accident from on-screen menus and recorded and interpreted client responses as shown on videodisc. Multiple regressions were calculated in which grades and simulation scores were used to predict fieldwork supervisor ratings.
RESULTS. In cohort 1, grade in a physical disabilities course predicted 31% of the variance in supervisor ratings, whereas the simulation score for “completeness” accounted for an additional 12%, F(2, 39) = 16.75, p < .0001, adjusted R 2 = .434. Students with better grades received higher ratings, whereas students who evaluated the simulated client less exhaustively received higher ratings. For cohort 2, fieldwork ratings were best predicted by a combination of several simulation efficiency scores (number of correct answers given per unit time), F(4, 21) = 6.17, p < .002, adjusted R 2 = .453. Mostly, higher efficiency scores were associated with higher supervisor ratings.
CONCLUSION. Video simulations of client encounters may measure decision-making skills not measured by grades, in particular, making correct decisions in a timely manner within a realistic context.