在本科医学教育中对临床推理过程进行新型形成性客观结构化临床检查的评估:试点研究
Thai Ong1, Hyeryung Lee2, Su Somay1
1National Board of Medical Examiners, Philadelphia, PA, United States.
概括
本研究介绍了临床推理的客观结构化临床检查 (OSCE-CR),这是一个新的评估工具. 欧安组织CR有效地测量临床推理过程,并预测医学学生的诊断准确性.
科学领域:
- 医学教育 医学教育
- 临床推理评估评估
- 心理测量 心理测量 心理测量
背景情况:
- 当前的临床推理评估往往侧重于结果,忽视了潜在的推理过程.
- 国家医学检查员委员会开发了临床推理的客观结构化临床检查 (OSCE-CR) 来弥补这个差距.
- 欧安组织-CR利用标准化的患者接触来评估三个临床推理子领域的学生行为.
研究的目的:
- 评估欧安组织CR的心理测量特性.
- 确定OSCE-CR作为医学本科教育中的形成性评估工具的实用性.
- 为在临床推理评估中使用基于过程的指标提供证据.
主要方法:
- 一项大规模的试点研究涉及76名在美国4所医学院的职员生.
- 学生完成了4个标准化的病例,视频由训练有素的教师对3个临床推理子域进行评分.
- 多变量通用性理论 (G理论) 和通用线性混合建模 (GLMM) 用于分析.
主要成果:
- 多变量G理论表明了子域 (Φ=0.466) 和复合分数 (Φ=0.738) 的可接受可靠性.
- 可靠性受到评估中包含的案件数量的影响.
- 据GLMM证实,OSCE-CR综合评分对诊断准确性进行了积极预测 (P=.03).
结论:
- 欧安组织-CR展示了初步的心理测量证据,用于测量与诊断准确性相关的临床推理过程.
- 这种评估超越了基于结果的措施,允许对流程相关行为的反.
- 欧安组织-CR可以帮助学生提高临床推理技能,减少诊断错误.
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