Wessel Jean, Williams Renee, Finch Elspeth, Gémus Maryan
School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, Ontario, Canada L8S 1C7.
J Allied Health. 2003 Winter;32(4):266-9.
The purpose of this study was to examine the reliability and validity of an objective structured clinical examination (OSCE) for students in the first year of a 2-year physical therapy program. Forty-eight students were examined at eight stations in one of two duplicate OSCE circuits. The stations evaluated skills required for the management of persons with chronic musculoskeletal conditions. At each station, students were required to interact with patients, demonstrate techniques, or interpret observations. Checklists were used to score all stations, which had equal values. The associations among stations were examined using Pearson's correlations and Cronbach's alpha. A two-way analysis of variance (ANOVA) with repeated measures was used to determine differences among stations and between circuits. The validity of the OSCE was evaluated by determining the correlations between scores on the stations and performance in a subsequent clinical practicum. Correlations between stations were r = -0.14 to 0.33 and between stations and clinical performance were r = -0.28 to 0.27. Cronbach's alpha was 0.48. The ANOVA revealed significant differences among stations (F = 62.6, p = 0.000) but not between circuits (F = 1.8, p = 0.185). There was no significant interaction between circuit and station (F = 1.1, p = 0.356). There was poor internal consistency of the OSCE, and it did not predict clinical performance. Further research is required to determine if a larger number of stations can reliably and validly assess clinical skills of physical therapy students.
本研究的目的是检验客观结构化临床考试(OSCE)对两年制物理治疗项目一年级学生的可靠性和有效性。48名学生在两个重复的OSCE流程之一的八个站点接受了测试。这些站点评估了管理慢性肌肉骨骼疾病患者所需的技能。在每个站点,学生需要与患者互动、演示技术或解释观察结果。使用检查表对所有站点进行评分,各站点分值相等。使用Pearson相关性分析和Cronbach's alpha检验各站点之间的关联。采用重复测量的双向方差分析(ANOVA)来确定各站点之间以及两个流程之间的差异。通过确定站点得分与后续临床实习表现之间的相关性来评估OSCE的有效性。各站点之间的相关性为r = -0.14至0.33,站点得分与临床实习表现之间的相关性为r = -0.28至0.27。Cronbach's alpha为0.48。方差分析显示各站点之间存在显著差异(F = 62.6,p = 0.000),但两个流程之间没有显著差异(F = 1.8,p = 0.185)。流程与站点之间没有显著的交互作用(F = 1.1,p = 0.356)。OSCE的内部一致性较差,且无法预测临床实习表现。需要进一步研究以确定更多数量的站点能否可靠且有效地评估物理治疗专业学生的临床技能。