Hobma S O, Ram P M, Muijtjens A M M, Grol R P T M, van der Vleuten C P M
Department of General Practice, Centre for Quality of Care Research, University of Maastricht, Maastricht, The Netherlands.
Med Educ. 2004 Dec;38(12):1244-52. doi: 10.1111/j.1365-2929.2004.01918.x.
Continuing professional development (CPD) of general practitioners.
Criterion-referenced standards for assessing performance in the real practice of general practitioners (GPs) should be available to identify learning needs or poor performers for CPD. The applicability of common standard setting procedures in authentic assessment has not been investigated.
To set a standard for assessment of GP-patient communication with video observation of daily practice, we investigated 2 well known examples of 2 different standard setting approaches. An Angoff procedure was applied to 8 written cases. A borderline regression method was applied to videotaped consultations of 88 GPs. The procedures and outcomes were evaluated by the applicability of the procedure, the reliability of the standards and the credibility as perceived by the stakeholders, namely, the GPs.
Both methods are applicable and reliable; the obtained standards are credible according to the GPs.
Both modified methods can be used to set a standard for assessment in daily practice. The context in which the standard will be used - i.e. the specific purpose of the standard, the moment the standard must be available or if specific feedback must be given - is important because methods differ in practical aspects.
全科医生的持续专业发展（CPD）。
应制定基于标准参照的评估标准，以评估全科医生（GPs）在实际临床工作中的表现，从而确定其继续职业发展的学习需求或表现不佳者。尚未对通用标准设定程序在真实评估中的适用性进行研究。
为了通过日常实践的视频观察来设定评估全科医生与患者沟通的标准，我们研究了两种不同标准设定方法的两个著名示例。将安格夫程序应用于8个书面案例。将边界回归方法应用于88名全科医生的视频会诊。通过程序的适用性、标准的可靠性以及利益相关者（即全科医生）所感知的可信度对程序和结果进行评估。
两种方法均适用且可靠；根据全科医生的反馈，所获得的标准是可信的。
两种改进方法均可用于设定日常实践中的评估标准。标准的使用背景——即标准的具体目的、标准必须可用的时间或是否必须提供特定反馈——很重要，因为不同方法在实际操作方面存在差异。
