Hatala Rose, Kassen Barry O, Nishikawa James, Cole Gary, Issenberg S Barry
Department of Medicine, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada.
Acad Med. 2005 Jun;80(6):554-6. doi: 10.1097/00001888-200506000-00007.
High-stakes assessment of clinical performance through the use of standardized patients (SPs) is limited by the SP's lack of real physical abnormalities. The authors report on the development and implementation of physical examination stations that combine simulation technology in the form of digitized cardiac auscultation videos with an SP assessment for the 2003 Royal College of Physicians and Surgeons of Canada's Comprehensive Objective Examination in Internal Medicine. The authors assessed candidates on both the traditional stations and the stations that combined the traditional SP examination with the digitized cardiac auscultation video. For the combined stations, candidates first completed a physical examination of the SP, watched and listened to a computer simulation, and then described their auscultatory findings. The candidates' mean scores for both types of stations were similar, as were the mean discrimination indices for both types of stations, suggesting that the combined stations were of a testing standard similar to the traditional stations. Combining an SP with simulation technology may be one approach to the assessment of clinical competence in high-stakes testing situations.
通过使用标准化病人（SPs）对临床能力进行高风险评估，受到SP缺乏真实身体异常情况的限制。作者报告了体检站的开发与实施情况，这些体检站将数字化心脏听诊视频形式的模拟技术与2003年加拿大皇家内科医师和外科医师学院内科综合客观考试的SP评估相结合。作者在传统站点以及将传统SP检查与数字化心脏听诊视频相结合的站点上对考生进行了评估。对于组合站点，考生首先对SP进行体格检查，观看并聆听计算机模拟，然后描述他们的听诊结果。两种类型站点的考生平均分数相似，两种类型站点的平均区分指数也相似，这表明组合站点的测试标准与传统站点相似。将SP与模拟技术相结合可能是在高风险测试情境中评估临床能力的一种方法。
