Lockyer Jocelyn M, Violato Claudio, Fidler Herta
Continuing Medical Education and Professional Development, Faculty of Medicine, University of Calgary, 3330 Hospital Drive N.W., Calgary, Alberta, T2N 4N1, Canada.
Can J Anaesth. 2006 Jan;53(1):33-9. doi: 10.1007/BF03021525.
To assess the feasibility, validity, and reliability of a multi source feedback program for anesthesiologists.
Surveys with 11, 19, 29 and 29 items were developed for patients, coworkers, medical colleagues and self, respectively, using five-point scales with an 'unable to assess' category. The items addressed communication skills, professionalism, collegiality, continuing professional development and collaboration. Each anesthesiologist was assessed by eight medical colleagues, eight coworkers, and 30 patients. Feasibility was assessed by response rates for each instrument. Validity was assessed by rating profiles, the percentage of participants unable to assess the physician for each item, and exploratory factor analyses to determine which items grouped together into scales. Cronbach's alpha and generalizability coefficient analyses assessed reliability.
One hundred and eighty-six physicians participated. The mean number and percentage return rate of respondents per physician was 17.7 (56.2%) for patients, 7.8 (95.1%) for coworkers, and 7.8 (94.6%) for medical colleagues. The mean ratings ranged from four to five for each item on each scale. There were relatively few items with high percentages of 'unable to assess'. The factor analyses revealed a two-factor solution for the patient, a two-factor solution for the coworker and a three-factor solution for the medical colleague survey, accounting for at least 70% of the variance. All instruments had a high internal consistency reliability (Cronbach's alpha > 0.95). The generalizability coefficients were 0.65 for patients, 0.56 for coworkers and 0.69 for peers.
It is feasible to develop multi source feedback instruments for anesthesiologists that are valid and reliable.
评估针对麻醉医生的多源反馈项目的可行性、有效性和可靠性。
分别为患者、同事、医学同行和自我设计了包含11项、19项、29项和29项内容的调查问卷,采用五分制量表,设有“无法评估”类别。这些项目涉及沟通技巧、专业素养、团队合作、持续专业发展和协作。每位麻醉医生由8名医学同行、8名同事和30名患者进行评估。通过每种工具的回复率评估可行性。通过评分概况、各项目中无法评估医生的参与者百分比以及探索性因素分析来确定哪些项目归为同一量表,以此评估有效性。采用克朗巴哈系数和概化系数分析评估可靠性。
186名医生参与。每位医生的患者平均回复数量和回复率为17.7(56.2%),同事为7.8(95.1%),医学同行为7.8(94.6%)。每个量表上每个项目的平均评分在4至5分之间。“无法评估”百分比高的项目相对较少。因素分析显示患者调查问卷为两因素解决方案,同事调查问卷为两因素解决方案,医学同行调查问卷为三因素解决方案,解释了至少70%的方差。所有工具都具有较高的内部一致性可靠性(克朗巴哈系数>0.95)。患者的概化系数为0.65,同事为0.56,同行的为0.69。
为麻醉医生开发有效且可靠的多源反馈工具是可行的。