泌尿病学检查员得分的观察者间差异 目标 结构化 临床检查
Naji J Touma1, Charles A Paco2, Iain MacIntyre1
1Department of Urology, Queen's University, Kingston, ON, Canada.
概括
泌尿器科住院医生的客观结构化临床检查 (OSCE) 评分在观察者之间的一致性因病房而异. 虽然大多数站都显示出良好的可靠性,但对于高风险的评估,需要仔细考虑.
科学领域:
- 医学教育 医学教育
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 评估评估的方法
背景情况:
- 客观结构化临床检查 (OSCE) 是评估高风险总结检查能力的宝贵工具.
- 欧安组织提供对临床背景,内容和程序的现实评估.
- 皇后泌尿科考试技能培训 (QUEST) 利用欧安组织为加拿大泌尿科居民准备参加董事会考试.
研究的目的:
- 评估在泌尿器科欧安组织期间两个独立检查员之间的评分的观察者间一致性.
- 确定欧安组织在不同临床站的评分可靠性.
主要方法:
- 2020年有39名参与者和2021年有37人通过Zoom完成了四个虚拟的欧安组织站.
- 两个失明的泌尿病学教员独立地使用检查清单评分表给每位候选人打分.
- 进行了类内相关性 (ICC) 分析,以评估每个站的评分器间可靠性.
主要成果:
- 2020年,前列腺癌站显示了最高的评价者间可靠性 (ICC 0.746),其次是一般泌尿学 (0.688),尿失禁 (0.638) 和质病 (0.472).
- 在2021年,癌的可靠性最高 (ICC为0.866),其次是结石病 (0.817),儿科 (0.809) 和雄性病 (0.804).
- 所有站都显示出与整体考试成绩的正相关性,尽管高预测能力并不总是等同于更高的评分间可靠性.
结论:
- 在欧安组织评分中,评价者之间的可靠性可能不一致,特别是在特定的临床场景中.
- 欧安组织的标准化至关重要,尤其是在做出高风险决策时,例如提升候选人.
- 评分的变化凸显了需要仔细解释欧安组织在泌尿病住院评估结果的需要.
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