Paisley Anna M, Baldwin Pamela J, Paterson-Brown Simon
Department of Clinical and Surgical Sciences, Royal Infirmary, Edinburgh, UK.
Med Teach. 2005 Nov;27(7):634-8. doi: 10.1080/01421590500251175.
The aim of this study was to determine the accuracy of medical staff assessment of trainees' operative competence. Over 18 months all 36 basic surgical trainees in SE Scotland were evaluated at the end of each attachment by consultants and registrars on their ability to perform key operative procedures using a previously validated assessment form. Frequency of assessment was compared with: (1) trainee's recording of whether the specific assessor had actually directly supervised them performing the procedure and (2) number of supervised procedures performed by trainees as determined by logbook data. A high percentage of both assessor groups provided assessment of procedures which they had not observed. Only 19/102 consultants and 20/95 registrars assessed only those procedures directly observed. A median of 9% (range 0-54%) of staff provided assessment for procedures that trainees had never even performed during that attachment. Such discrepancy needs to be addressed if accurate assessment of competence is to be achieved by trainers.
本研究的目的是确定医务人员对实习医生手术能力评估的准确性。在18个月的时间里,苏格兰东南部的所有36名基础外科实习医生在每次实习结束时,由顾问医生和住院医生使用先前验证过的评估表,对他们执行关键手术程序的能力进行评估。将评估频率与以下两项进行比较:(1)实习医生记录特定评估者是否实际直接监督他们进行该程序;(2)根据日志数据确定的实习医生接受监督的手术程序数量。两个评估者组中都有很高比例的人对他们未观察到的程序进行了评估。只有19/102名顾问医生和20/95名住院医生仅对直接观察到的程序进行评估。有9%(范围为0 - 54%)的工作人员对实习医生在该实习期间甚至从未执行过的程序进行了评估。如果培训人员要实现对能力的准确评估,就需要解决这种差异。