Evaluating Clinical Problem-Solving Skills through Computer Simulations

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Evaluating Clinical Problem-Solving Skills Through Computer Simulations

Computer-aided instruction (CAI) is an effective teaching technique that has existed for almost two decades (Braun, 1980; Frenzel, 1980; Gerhold, 1978; Office of Technology Assessment, 1979). The primary advantage of CAI over traditional classroom teaching methods appears to be the automatic interaction and immediate feedback that the computer can provide to students on an individual basis (Frenzel, 1980). In addition, CAI is an exciting, interesting, and valid way of introducing students to the use of modern computers. Unfortunately, because of the historically high cost of electronic computing on large mainframe computers and medium-size minicomputers, CAI has not been used extensively. However, with the advent of large-scale integrated (LSI) circuits and the introduction of personal microcomputers, the cost of CAI computing is no longer prohibitive. As a result, there is currently a resurgent interest in the application of computers in education (Frenzel, 1980).

In rehabilitation, the provision of high-quality services to large numbers of clients with a wide variety of disabling conditions and rehabilitation needs is a great challenge to counselors (Cox, Connolly, & Flynn, 1981). To meet this challenge, rehabilitation counselors must develop not only strong clinical and counseling skills, but must also possess strong case management skills in the areas of problem-solving, time usage, budgeting, communication, use of community resources, and documentation as well. Although the professional preparation of rehabilitation counselors devotes a considerable amount of time to developing clinical and counseling skills, it has been only recently that consideration has been given to preparation in case management (Cox, Connolly, & Flynn, 1981). This lack of attention can be attributed to the fact that case management skills are more readily developed through hands-on experience and it is difficult to simulate this experience in a classroom setting.

To facilitate training in this area, computerized case management simulation programs have been developed to help rehabilitation counselor trainees develop appropriate clinical problem-solving and case management skills. Because undergraduate and graduate level rehabilitation services students are frequently employed as rehabilitation counselors in state vocational rehabilitation agencies, it is logical to assume that they could also benefit from case simulation exercises. Berven and his colleagues have developed a series of case management simulation programs (based on state vocational rehabilitation agency materials) on large mainframe computers (Berven, 1985; Berven & Scofield, 1980) and microcomputers (Chan, Parker, Lam, Mecaskey & Malphurs, 1987). They used computer simulations to compare clinical and graduate problem-solving skills of undergraduate and graduate rehabilitation students with experienced rehabilitation counselors. The computer simulation results have provided encouraging reliability and validity data and have successfully differentiated case performance among rehabilitation counseling students (Berven, 1985; Berven & Scofield, 1980; Chan et al., 1987). However, Berven and Scofield's original 1980 study, with only 12 counselors forming the performance standard for comparison purposes is tentative at best. If a study with a large representative sample of counselors and students is not possible, then a series of local validation studies conducted across the country maybe necessary to provide further evidence of psychometric properties for computer simulations to be considered a valid assessment and teaching tool in rehabilitation education.

The purpose of this study was to validate the appropriateness of the computerized case simulation program developed by Berven and Scofield (1980) as a tool to evaluate case management performance using a sample of rehabilitation students and rehabilitation counselors in the state of Texas. …