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¿El nivel de PGY equivale al nivel de confianza? Variabilidad en las calificaciones de la facultad

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La facultad muestra variabilidad en la calificación de las actividades profesionales confiables (EPA) de los residentes quirúrgicos. Los residentes mayores (PGY3-5) tenían puntuaciones de confianza más altas y una mayor variabilidad de puntuación que los residentes menores (PGY1-2).

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Área de la Ciencia:

  • Educación médica
  • Entrenamiento quirúrgico
  • Educación basada en competencias

Sus antecedentes:

  • El marco de actividades profesionales confiables (EPA) es crucial para evaluar la competencia de los residentes en la educación médica.
  • Existen datos limitados sobre la variabilidad de la facultad en la asignación de niveles de confianza dentro del marco de la EPA, particularmente en cirugía general.

Objetivo del estudio:

  • Evaluar la variabilidad de la facultad en las calificaciones de nivel de confianza para los residentes de cirugía general en diferentes años de posgrado (PGY).
  • Para comparar la variabilidad de la puntuación de confianza entre residentes menores (PGY1-2) y mayores (PGY3-5).

Principales métodos:

  • Recogió 1108 evaluaciones de EPA intra-operativas de 52 evaluadores de la facultad durante un año.
  • Variación calculada de la puntuación de la EPA para los calificadores individuales dentro de los niveles de PGY, excluidos los que tienen menos de 5 evaluaciones.
  • Se utilizó la prueba de Levene y la corrección de Bonferroni para la comparación de la variabilidad y modelos mixtos lineales para la comparación de la puntuación media.

Principales resultados:

  • Las puntuaciones medias de confianza aumentaron significativamente con PGY (1.72 para PGY1 a 3.33 para PGY5).
  • Los residentes más jóvenes (PGY1-2) alcanzaron niveles de confianza más bajos (1-3) sin diferencias significativas en la variabilidad entre ellos.
  • Los residentes de edad avanzada (PGY3-5) mostraron un rango más amplio de confianza (2-4) con una confianza general y una variabilidad de puntuación significativamente más altas en comparación con los jóvenes.

Conclusiones:

  • Los profesores muestran una variabilidad considerable en la asignación de puntajes EPA a los residentes dentro del mismo nivel de PGY.
  • El aumento de la variabilidad en las calificaciones de la EPA para los residentes mayores sugiere un desarrollo diferencial de las habilidades operativas.
  • Los hallazgos destacan la necesidad de una evaluación y retroalimentación estandarizadas de la facultad dentro de los programas de capacitación quirúrgica basados en competencias.