Pugh Carla M, Youngblood Patricia
Stanford University School of Medicine, Stanford, California 94305-5466, USA.
J Am Med Inform Assoc. 2002 Sep-Oct;9(5):448-60. doi: 10.1197/jamia.m1107.
Define, extract and evaluate potential performance indicators from computer-generated data collected during simulated clinical female pelvic examinations.
Qualitative and quantitative study analyzing computer generated simulator data and written clinical assessments collected from medical students who performed physical examinations on three clinically different pelvic simulators.
Introduction to patient care course at a major United States medical school.
Seventy-three pre-clinical medical students performed 219 simulated pelvic examinations and generated 219 written clinical assessments.
Cronbach's alpha for the newly defined performance indicators, Pearson's correlation of performance indicators with scored written clinical assessments of simulator findings.
Four novel performance indicators were defined: time to perform a complete examination, number of critical areas touched during the exam, the maximum pressure used, and the frequency at which these areas were touched. The reliability coefficients (alpha) were time = 0.7240, critical areas = 0.6329, maximum pressure = 0.7701, and frequency = 0.5011. Of the four indicators, three correlated positively and significantly with the written clinical assessment scores: critical areas, p < 0.01; frequency, p < 0.05; and maximum pressure, p < 0.05.
This study demonstrates a novel method of analyzing raw numerical data generated from a newly developed patient simulator; deriving performance indicators from computer generated simulator data; and assessing validity of those indicators by comparing them with written assessment scores. Results show the new assessment measures provide an objective, reliable, and valid method of assessing students' physical examination techniques on the pelvic exam simulator.
从模拟临床女性盆腔检查期间收集的计算机生成数据中定义、提取并评估潜在的性能指标。
定性和定量研究,分析计算机生成的模拟器数据以及从对三种临床不同盆腔模拟器进行体格检查的医学生收集的书面临床评估。
美国一所主要医学院的患者护理课程介绍。
73名临床前医学生进行了219次模拟盆腔检查,并生成了219份书面临床评估。
新定义性能指标的克朗巴哈系数,性能指标与模拟器检查结果书面临床评估得分的皮尔逊相关性。
定义了四个新的性能指标:完成一次完整检查的时间、检查期间触及的关键区域数量、使用的最大压力以及这些区域被触及的频率。可靠性系数(α)分别为:时间 = 0.7240,关键区域 = 0.6329,最大压力 = 0.7701,频率 = 0.5011。在这四个指标中,有三个与书面临床评估得分呈显著正相关:关键区域,p < 0.01;频率,p < 0.05;最大压力,p < 0.05。
本研究展示了一种分析新开发患者模拟器生成的原始数值数据的新方法;从计算机生成的模拟器数据中得出性能指标;并通过将这些指标与书面评估得分进行比较来评估其有效性。结果表明,新的评估措施为评估学生在盆腔检查模拟器上的体格检查技术提供了一种客观、可靠且有效的方法。