Wayne Diane B, Butter John, Siddall Viva J, Fudala Monica J, Wade Leonard D, Feinglass Joe, McGaghie William C
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Med Teach. 2006 Jun;28(4):365-9. doi: 10.1080/01421590600627821.
Internal medicine residents in the US must be competent to perform procedures including Advanced Cardiac Life Support (ACLS) to become board-eligible. Our aim was to determine if residents near graduation could assess their skills in ACLS procedures accurately. Participants were 40 residents in a university-based training program. Self-assessments of confidence in managing six ACLS scenarios were measured on a 0 (very low) to 100 (very high) scale. These were compared to reliable observational ratings of residents' performance on a high-fidelity simulator using published treatment protocols. Residents expressed strong self-confidence about managing the scenarios. Residents' simulator performance varied widely (range from 45% to 94%). Self-confidence assessments correlated poorly with performance (median r = 0.075). Self-assessment of performance by graduating internal medicine residents was not accurate in this study. The use of self-assessment to document resident competence in procedures such as ACLS is not a proxy for objective evaluation.
在美国，内科住院医师必须有能力执行包括高级心脏生命支持（ACLS）在内的操作，才能获得参加资格考试的资格。我们的目的是确定临近毕业的住院医师是否能够准确评估自己在ACLS操作方面的技能。研究对象为参加大学培训项目的40名住院医师。他们对六种ACLS场景管理的信心进行了自我评估，评估范围为0（非常低）至100（非常高）。将这些自我评估结果与使用已发表治疗方案在高保真模拟器上对住院医师表现进行的可靠观察评分进行比较。住院医师对场景管理表现出很强的自信心。住院医师在模拟器上的表现差异很大（范围从45%到94%）。自信心评估与表现的相关性很差（中位数r = 0.075）。在本研究中，即将毕业的内科住院医师对自身表现的自我评估并不准确。使用自我评估来记录住院医师在ACLS等操作方面的能力，并非客观评估的替代方法。
