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高级外科住院医师对ACGME里程碑上的初级住院医师的评估
Deirdre Sheets1, Adam Ayoub1, Clayton Wyland1
1Western Michigan University, Homer Stryker MD School of Medicine, Kalamazoo, Michigan.
Journal of surgical education
|October 10, 2025
概括
居民自我评估与教师评估密切相关,但首席居民对居民的评分更高,这表明需要评估首席居民对评估过程的理解.
科学领域:
- 医学教育 医学教育
- 居民评估的评估.
- 基于能力的教育 基于能力的教育
背景情况:
- 研究生医学教育认证委员会 (ACGME) 要求每半年使用基于能力的发展成果 (里程碑) 进行居民评估.
- 使用里程碑的自我评估 (SE) 允许居民批判性地评估自己的能力.
- 本研究探讨了自我评估 (SE),临床能力委员会 (CCC) 和首席医生 (CRs) 之间的住院绩效评估的协调.
研究的目的:
- 为了比较三个不同的评级组的居民绩效评估:自我评估 (SE),临床能力委员会 (CCC) 和首席住院人员 (CRs).
- 评估居民审查过程的全面性和质量,探索包括首席居民 (CR) 评估的价值.
- 为了确定居民里程碑的SE,CCC和CR评估之间的interrater可靠性.
主要方法:
- 对2019年7月至2024年6月期间PGY1-PGY4级居民的里程碑分数的回顾性分析.
- 评估六个核心能力:患者护理,医疗知识,专业精神,人际关系/沟通技巧,基于实践的学习和改进以及基于系统的实践.
- 统计分析包括ANOVA来比较群体差异和类内相关性 (ICC) 以评估CCC-SE,SE-CR和CCC-CR评估之间的interrater可靠性使用SPSS.
主要成果:
- 自我评估 (SE) 和临床能力委员会 (CCC) 的评估显示了类似的分数.
- 首席住户 (CRs) 的住户得分明显高于SE和CCC评估 (p < 0.001).
- 在SE和CCC之间发现了出色的interrater可靠性 (ICC>0.90),而SE/CCC和CR之间的可靠性从差到中等 (ICC 0.24-0.73).
结论:
- 居民自我评估显示出与临床能力委员会评估的强烈一致.
- 首席住院医生倾向于将较高的分数分配给初级住院医生,而不是自我评估和CCC评估.
- 鉴于与SE和CCC相比的不同结果,进一步评估首席医生对评估过程的理解是有必要的.
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