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The problem of goal attainment scaling as an outcome measure

04 Aug 2017 9:05 PM | William Levack (Administrator)

Goal setting in rehabilitation is a topic that I have written a lot about of the past ten plus years – both in term of research publications and textbooks.  It’s a topic that has a lot of currency with health professionals, and is something that I’m frequently asked to talk about at conferences and workshops.  (In fact, I developed a distance-taught postgraduate paper for people wanting to develop their knowledge and skills in this area of clinical practice.)

One aspect of goal setting that I’m often asked to comment on is the use of goal attainment scaling (GAS) as an outcome measure in rehabilitation.  In fact, I have a number reservations about goal attainment in general as an outcome measure.  My opinion is that goal setting is an extremely important part of the rehabilitation process, but is probably more important for communication of expectations, shared decision making, and motivation of patients and health professionals than it is for demonstrating the effectiveness of rehabilitation services.  We have other tools for evaluating health outcomes – namely psychometricallyvalid, standardised outcome measures.

So, recently when I was asked to contribute a chapter on goal setting for the 4th edition of Physical Management for Neurological Conditions (due to be published in 2018), I took the opportunity to explore the topic of using goal achievement as an outcome measure in more detail.  Below is a video that I put together to summarise the key points that I raise on this topic in the book chapter. For a more detailed discussion of these issues and for my other latest content on goal setting in neurorehabilitation, I encourage you to get hold of a copy of this textbook when it come out later next year.

(Footnote: The sound in this video is a little sketchy because I filmed it in my home, in a room with a lot of echo, and on an old family camera. There's only so much fixing of sound and image quality one can do after filming it turns out. I'm still learning how to be a rehab YouTuber!)

William Levack is an Associate Professor of Rehabilitation at the Rehabilitation Teaching & Research Unit, University of Otago, Wellington, New Zealand. Twitter: @DrLevack

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