A customer reflects on using Q-global Digital Stimulus Books and Manuals:
Q-Global has been a great solution for us. Managing testing materials between a variety of sites and districts could be very tricky. The online testing materials have completely resolved any access challenges we faced. Observing and recording the client's response through telepractice continues to require a good deal of coordination- particularly for pointing activities. However, the clinician being able to directly manage test stimuli and present them to the client through screen share technology makes that process much less cumbersome.
Thank you for being so proactive with making your tools accessible to telepractitioners!
Nate Cornish, M.S., CCC-SLP
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What is telepractice (a.k.a. telemedicine or telehealth)?
Formally defined, telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patient's clinical health status. Telemedicine includes a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology.
- Watch an example of intervention and assessment within a telepractice session from Pearson's Connections Education group.
Telemedicine is not a separate medical specialty. Even in the reimbursement fee structure, there is usually no distinction made between services provided on site and those provided through telemedicine and often no separate coding required for billing of remote services. The American Telemedicine Association (ATA) has historically considered telemedicine and telehealth to be interchangeable terms, encompassing a wide definition of remote healthcare. Patient consultations via video conferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education, consumer-focused wireless applications and nursing call centers, among other applications, are all considered part of telemedicine and telehealth" (American Telemedicine Association, 2014).
In 2010, the American Telemedicine Association published a sample set of guidelines for telepractice.
- A Blueprint for Telerehabilitation Guidelines
Other professional organizations also have developed formal statements or documents relating to telepractice. For example:
- American Psychological Association (APA)
- American Speech-Language-Hearing Association (ASHA)
- American Occupational Therapy Association (AOTA)
- American Medical Association (AMA)
Across each professional practice domain, there are many different but related terms used to describe this service delivery model. Pearson Clinical Assessment uses the term telepractice as an umbrella term to reflect the most broad sense of the concept across the most settings, including schools, medical facilities, private practices, outpatient clinics, home-based care and others. The term telepractice also encompasses the broad array of activities currently used within this model, including interprofessional collaboration, consultation, direct service, supervision and more.
Assessment via Telepractice: General Guidelines
The use of assessment tools is a key area of study within the larger telepractice landscape. As professionals begin to adopt any new service delivery tool or model, it is imperative that they consider all the surrounding issues related to this change in service delivery method.
In general, the appropriateness of use of a specific assessment tool in the context of telepractice should be considered carefully. First, you are responsible for checking local laws and regulations for your clinical practice. Second, you should refer to guidelines from your professional association (e.g., APA, AOTA, ASHA, AMA) for further recommendations. Finally, you may use the information provided by Pearson on specific products to assist you in your clinical decision-making.
Along with a thorough review of the laws, guidelines, and professional association documents, you should consider the following:
- the nature of the clinical relationship between the clinician and client--sometimes establishing a relationship face-to-face first is warranted
- the purpose of the assessment--it may not be appropriate to administer a test remotely if you need to ensure the correct individual is taking the test, or if you need to observe the actual test administration in detail, or if there is a legal circumstance that dictates an in-person evaluation.
- the availability of a trained aide or independent support personnel
- the availability of a remote testing environment that is free of distractions, and conducive to valid test taking.
The following statement from the American Telemedicine Association (ATA) reminds clinicians that the use of any assessment or therapy using telepractice methods should be undertaken only after careful consideration of all relevant information:
"Given the variability of rehabilitation clients, candidacy and appropriateness for telerehabilitation should be determined on a case-by-case basis with selections firmly based on clinical judgment, client's informed choice, and professional standards of care."
ATA - A Blueprint for Telerehabilitation Guidelines Guidelines, 2010, p.8
Pearson Clinical Assessment has compiled key references about the equivalence of paper and digital questionnaire responses, , and is conducting ongoing studies to examine the use of selected interactive assessment content in digital and telepractice contexts. Please see selected references on each product page which provide support for the equivalence of test results with digital administration and/or specific guidance regarding the use of our tools within a telepractice modality.
Implementation: A Five-Theme Framework
Specific issues in the delivery of assessment via telepractice include, but are not limited to:
- The age and characteristics of the examinee
- The skill, experience, and training level(s) of the examiner
- The assessment task format(s)
- Appropriate modifications of tasks delivered in a telepractice setting
- The data supporting the valid and reliable modification of any use of norm-referenced scores validated on a paper administration in a telepractice environment
- The legal requirements of any use of published test content in a telepractice context
A five-theme framework (Eichstadt, Castilleja, Jakubowitz, & Wallace, 2013) for addressing issues of assessment in telepractice may be helpful in identifying key areas of focus or concern for each assessment. The five themes are:
- Audio/Visual Environment (e.g., sound quality, video quality, background distractions)
- Examiner Factors (e.g., technological competence, familiarity with the test)
- Examinee Factors (e.g., behavior, fatigue level, comfort with technology)
- Test/Test Materials (e.g., type of task to be administered, format of stimulus, ease of use)
- Other/Miscellaneous (e.g., purpose of the administration, nature of clinical relationship)
Please note that any change in the currently published formats of any test requires prior permission from Pearson before you begin to manipulate any copyrighted material. See the Legal Policies on our website for additional detail.
Pearson Clinical Assessment has a growing number of products that may be appropriately used for telepractice under certain conditions. Please keep in mind that local laws and regulations apply and must be considered first in each case. Any specific guidance available for a given test can be found on the individual product pages on this website. If you don't see information on a particular product, please contact us online for assistance.