Type of Project: Study
Functional Capacity Evaluation (FCE) systems for assessing work-related performance: inventory and expert assessment (FCE study)

FCE systems are assessments for the evaluation of work-related performance. The starting point of the study was the increasing use of FCE systems in Germany. The aim of the study was to obtain greater transparency about the use of FCE systems. To this end, a comprehensive inventory and an evaluation of the use of FCE in the field of rehabilitation and socio-medical assessment was conducted by experts. By means of two written surveys, almost all of the then existing facilities with FCE systems, i.e. about 50, in Germany were interviewed. For comparison, rehabilitation facilities that planned to use it (n=28) and rehabilitation facilities without FCE systems were also included (n=238). The project was concluded by an expert meeting with representatives of the participating facilities, rehabilitation scientists, social physicians, etc. Results: The two systems primarily used in the Federal Republic of Germany, EFL (according to Isernhagen) and ERGOS, are very similar, both with regard to the basic principles and the objective. They are based on key elements of physical job requirements listed in the Dictionary of Occupational Titles of the U.S. Department of Labor and conduct tests to assess physical performance in working life. While EFL determines performance largely by means of standardized observation, ERGOS determines performance primarily by means of computer-assisted measurement data. Since the end of the 1990s, the number of FCE systems has also been increasing in Germany, with the EFL, which is less expensive to purchase, being used by significantly more institutions than ERGOS (54 EFL, 12 ERGOS, as of January 2003). Up to now, EFL has been used primarily in orthopedic and neurological rehabilitation, ERGOS in vocational rehabilitation, i.e. in Vocational Training Centres. FCE systems provide test results independent of the type of injury, on the basis of which an assessment of (long-term) performance in the hourly range and of the possible severity of work in general or in relation to the activities tested can be made. They can thus facilitate the comparison between requirement and performance profile. A satisfactory physical capacity is in any case a prerequisite for the performance of the test. The reason for using the systems is often a long-term lack of clarity regarding physical performance. In many cases, the aim is to clarify whether and to what extent the requirements of the existing workplace can still be met. Also relevant is the question of which activities can still be performed or the assessment of performance capability with regard to the general labor market. It is important to formulate the question as precisely as possible in order to maximize the informative value of the FCE results. The informative value of the test results also depends to a large extent on the quality of the test administration, irrespective of the system used. Despite incomplete validation to date, the results of the tests are described as informative and, together with other available results and information, as a good basis for a socio-medical assessment. In general, however, the data extrapolated to the whole working day must be modified, e.g., on the basis of the disease prognosis or the (job) environment conditions. Standardized observational data (such as EFL), which include, for example, the influence of movement ergonomics, performance readiness, and compensatory capacity on work-related performance, are considered to have a high informative value. Performance results extrapolated from measured data (such as in ERGOS) should additionally be modified using standardized observational data. To shorten the long test duration (5-6 hours, spread over 2 days in EFL), screenings are developed for specific questions (e.g., service screening) or only individual modules of a system are used. Since FCE systems are focused on the physical domain, other test instruments are to be included as needed. Beyond activity-oriented diagnostics, activity-based therapy concepts for work-related therapy are being developed by some facilities. Overall, FCE systems raise awareness of more work- and activity-oriented diagnostics and can improve the transparency, rationality, and quality of socio-medical assessment.