利用手术结果评估技术技能。

Using operative outcome to assess technical skill.

作者信息

Szalay D, MacRae H, Regehr G, Reznick R

机构信息

Faculty of Medicine, University of Toronto, Center for Research in Education at the University Health Network, Toronto, Ontario, Canada.

出版信息

Am J Surg. 2000 Sep;180(3):234-7. doi: 10.1016/s0002-9610(00)00470-0.

DOI:10.1016/s0002-9610(00)00470-0

PMID:11084137

Abstract

BACKGROUND

This study examined whether an operative product and time to completion could serve as measures of technical skill.

METHODS

Nine final-year (PGY5) and 11 penultimate-year (PGY4) general surgery residents participated in a 6-station bench model examination. Time to completion was recorded. Twelve faculty surgeons (2 per station) evaluated the quality of the final product using a 5-point scale.

RESULTS

The mean interrater reliability was 0. 59 for product quality. Interstation reliability was 0.59 for analysis of the final product and 0.72 for time to completion. There was 63% and 78% agreement between attendings' ratings and product quality and time scores respectively. PGY5s' mean product quality score was 4.14 +/- 0.26, compared with 3.82 +/- 0.33 for PGY4s (P < 0.05). PGY5s' mean time was 110 +/- 19 minutes compared with PGY4s' 132 +/- 15 (P < 0.05).

CONCLUSIONS

Analysis of the operative end product and time to completion offer efficient alternatives to on-line examiner scoring for bench model examinations of technical competence.

摘要

背景

本研究探讨了手术操作的最终成果及完成时间是否可作为技术水平的衡量指标。

方法

9名普外科住院医师最后一年（PGY5）及11名倒数第二年（PGY4）的住院医师参加了一场包含6个站点的模拟实验考核。记录完成时间。12名外科教员（每个站点2名）使用5分制对最终成果的质量进行评估。

结果

成果质量的评分者间平均信度为0.59。最终成果分析的站点间信度为0.59，完成时间的站点间信度为0.72。主治医生评分与成果质量及时间得分之间的一致性分别为63%和78%。PGY5的平均成果质量得分为4.14±0.26，而PGY4为3.82± 0.33（P<0.05）。PGY5的平均用时为110±19分钟，而PGY4为132±15分钟（P<0.05）。