Kreiter C D, Ferguson K J
University of Iowa College of Medicine, USA.
Eval Health Prof. 2001 Mar;24(1):36-46. doi: 10.1177/01632780122034768.
It is necessary to average multiple clinical evaluation form (CEF) observations to obtain a reliable score. Combining CEF observations across clerkships will provide more observations per student, but it is unknown how an across-clerkship generalization affects reliability. The authors conducted generalizability studies on balanced stratified random samples to examine the impact of averaging across clerkships. The study detected a student by clerkship interaction. Although the interaction magnitude was small, it had a large negative impact on the reliability of the mean score. The authors conclude that averaging across clerkships for the purpose of evaluating global clinical skills will produce a less reliable measure for a fixed number of observations than averages calculated within a clerkship for evaluating clerkship specific skills. The content specificity of clinical skills as measured by the CEF may resemble that found using other measurement methods.
有必要对多个临床评估表（CEF）观察结果进行平均，以获得可靠的分数。将不同临床实习阶段的CEF观察结果合并，将为每个学生提供更多观察数据，但尚不清楚跨临床实习阶段的概括对可靠性有何影响。作者对平衡分层随机样本进行了概化性研究，以检验跨临床实习阶段平均的影响。该研究发现了学生与临床实习阶段之间的交互作用。尽管交互作用的幅度较小，但对平均分数的可靠性有很大的负面影响。作者得出结论，为评估整体临床技能而对不同临床实习阶段进行平均，对于固定数量的观察结果而言，与在单个临床实习阶段内计算的平均值相比，会产生可靠性较低的测量结果。通过CEF测量的临床技能的内容特异性可能与使用其他测量方法所发现的相似。
