C V Granger1, A Deutsch, R T Linn. 1. Department of Rehabilitation Medicine, State University of New York at Buffalo 14214, USA.
Abstract
OBJECTIVE: To evaluate the range, distribution, and unidimensionality of the items included in Version Five of the Functional Independence Measure (FIM) Mastery Test, a 54-item written examination used to determine FIM rating proficiency by professionals who administer the instrument. STUDY DESIGN: Rasch analysis of the test results of 6,645 clinicians who took the FIM Mastery Test in 1996. RESULTS: Overall, clinicians performed well on the test. When the mean item difficulty was centered at 50, and the test scores were calibrated to range from 0 to 100 logits, the mean person ability level was 77 logits. Fit statistics indicated that the test was unidimensional, measuring a common theme. While the item separation index value was 17, 22 items were not efficient in determining the clinicians' ability levels. Analysis of the logit values by the correct response showed that descriptions of Total Assistance (Level 1) and Complete Independence (Level 7) were easiest for clinicians to score correctly. CONCLUSION: The examination measures the common theme of FIM knowledge in a consistent manner. Further, the results suggest that the FIM Mastery Test may be shortened, perhaps by eliminating one of the three case studies, and improved by adding more challenging questions. In addition, FIM training should focus on distinguishing among levels 2 through 6, since clinicians had more difficulty identifying these levels.
OBJECTIVE: To evaluate the range, distribution, and unidimensionality of the items included in Version Five of the Functional Independence Measure (FIM) Mastery Test, a 54-item written examination used to determine FIM rating proficiency by professionals who administer the instrument. STUDY DESIGN: Rasch analysis of the test results of 6,645 clinicians who took the FIM Mastery Test in 1996. RESULTS: Overall, clinicians performed well on the test. When the mean item difficulty was centered at 50, and the test scores were calibrated to range from 0 to 100 logits, the mean person ability level was 77 logits. Fit statistics indicated that the test was unidimensional, measuring a common theme. While the item separation index value was 17, 22 items were not efficient in determining the clinicians' ability levels. Analysis of the logit values by the correct response showed that descriptions of Total Assistance (Level 1) and Complete Independence (Level 7) were easiest for clinicians to score correctly. CONCLUSION: The examination measures the common theme of FIM knowledge in a consistent manner. Further, the results suggest that the FIM Mastery Test may be shortened, perhaps by eliminating one of the three case studies, and improved by adding more challenging questions. In addition, FIM training should focus on distinguishing among levels 2 through 6, since clinicians had more difficulty identifying these levels.
Authors: R Fitzpatrick; J M Norquist; C Jenkinson; B C Reeves; R W Morris; D W Murray; P J Gregg Journal: Qual Life Res Date: 2004-03 Impact factor: 4.147