Holmboe Eric S, Huot Stephen, Chung Jeff, Norcini John, Hawkins Richard E
Department of Medicine and the Yale Primary Care Internal Medicine Residency Program, Yale University School of Medicine, New Haven, Connecticut, USA.
Acad Med. 2003 Aug;78(8):826-30. doi: 10.1097/00001888-200308000-00018.
To investigate the construct validity of the miniclinical evaluation exercise (miniCEX).
Forty faculty participants from 16 internal medicine residency programs enrolled in a randomized, controlled trial of faculty development. Using a standard nine-point miniCEX rating form, participants watched and rated performances of standardized residents on nine scripted clinical videotapes depicting three levels of performance (unsatisfactory, marginal/satisfactory, and high satisfactory/superior). The nine-point rating scale was 1-3 = unsatisfactory, 4-6 = marginal/satisfactory, and 7-9 = superior. The performances were rated for three clinical skills, history taking, physical examination, and counseling.
For each of the three clinical skills, the faculty participants were able to successfully discriminate among the three levels of performance using the miniCEX scale. Differences among ratings of the three performance levels were statistically significant; however, the range in ratings among the participants for each videotape was wide.
The authors believe this to be the first study to document the construct validity of the miniCEX. Although the miniCEX appears to have reliability and construct validity, further research is needed to improve individual faculty observation skills and reduce interrater variability.
探讨迷你临床评估练习（miniCEX）的结构效度。
来自16个内科住院医师培训项目的40名教员参与了一项教员发展的随机对照试验。参与者使用标准的九点miniCEX评分表，观看并对9段脚本化临床录像带中标准化住院医师的表现进行评分，这些录像带描绘了三个表现水平（不满意、边缘/满意、高度满意/优秀）。九点评分量表为1 - 3分 = 不满意，4 - 6分 = 边缘/满意，7 - 9分 = 优秀。对三项临床技能进行评分，即病史采集、体格检查和咨询。
对于三项临床技能中的每一项，教员参与者都能够使用miniCEX量表成功区分三个表现水平。三个表现水平的评分差异具有统计学意义；然而，每个录像带参与者的评分范围较宽。
作者认为这是第一项记录miniCEX结构效度的研究。尽管miniCEX似乎具有信度和结构效度，但仍需要进一步研究以提高个体教员的观察技能并减少评分者间的变异性。
