Development and Testing of a Visual Tool for Assessing Risk of Falls

Background: To develop a "Time Pressure-Kiken Yochi Training (TP-KYT) system" for measuring risk prediction ability of health care professionals. Methods: The TP-KYT was developed using responses from 51 experts with at least 5 years of clinical experience (8.7 +/- 5.3 years). Participants extracted risk items by scoring 5 illustrations depicting fall-related medical accidents. With 77 "Experts" (34.0 +/- 5.6 years old; clinical experience, 9.1 +/- 4.8 years), 34 "Competents" (26.8 +/- 5.5 years old; clinical experience, 1.1 +/- 0.9 years), 34 "Advanced Beginners" (21.9 +/- 0.7 years old), and 44 "Novices" (18.7 +/- 1.9 years old), TP-KYT was validated using 1-way analysis of variance and Tukey's HSD (honestly significant difference) test. Risk prediction ability was evaluated using receiver operating characteristic curve analysis. Results: Experts scored significantly higher than others (Competents: P < .05; Advanced Beginners: P = 6.32E-10; and Novices: P = 4.53E-13). Area under the curve for Experts versus Competents was 0.73 and for Competents versus Advanced Beginners was 0.66. Sensitivity and specificity for Expert scores set at 212/213 were 54.5% and 82.4%, respectively, and for Competent scores set at 137/138 were 76.5% and 52.9%, respectively. The TP-KYT scores varied on the basis of the test taker's clinical experience. Conclusions: Validity and reliability of the TP-KYT were demonstrated. The TP-KYT can be a useful tool to quantify health professionals' ability to predict patients' fall risk under time pressure.