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针对妇产科住院医师和教员的技术技能观察结构化评估(OSATS)的建立与验证

Institution and validation of an observed structured assessment of technical skills (OSATS) for obstetrics and gynecology residents and faculty.

作者信息

Swift Steven E, Carter James F

机构信息

Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA.

出版信息

Am J Obstet Gynecol. 2006 Aug;195(2):617-21; discussion 621-3. doi: 10.1016/j.ajog.2006.05.032.

Abstract

OBJECTIVE

This study was undertaken to further evaluate the construct validity of the observed structured assessment of technical skills (OSATS) by comparing resident scores to faculty scores.

STUDY DESIGN

This study is a prospective blinded observational study. Four residents from each year (1-4) and 5 faculty members were examined. The OSATS examination was in the form of a dry laboratory with 10 stations: 4 laparoscopic and 6 open surgical skills. The sessions were videotaped and graded by the senior authors who used a task-specific checklist. The scoring of the videos was performed by the 2 senior authors blinded to the other examiners results. The examinations were videotaped, and the identity of the participants was blinded. The scores for each station were determined by adding all the numbers from the skills rating with a time score. Higher scores denote superior performance. Statistical analysis was performed with a nonparametric test (Kruskal-Wallis) for a total score with resident years divided into junior residents (first and second year), senior residents (third and fourth year), and faculty status as the independent variable. To determine the interrelater reliability between the 2 scores, the Kendall tau beta statistic was used.

RESULTS

The results show definite trends for 7 stations, with junior residents performing the worst and faculty performing the best. This trend was statistically significant for 6 of the 10 stations.

CONCLUSION

The OSATS examination has good construct validity that extends beyond residency to faculty.

摘要

目的

本研究旨在通过比较住院医师与教员的分数,进一步评估观察性结构化技术技能评估(OSATS)的结构效度。

研究设计

本研究是一项前瞻性盲法观察性研究。对每年(1-4年级)的4名住院医师和5名教员进行了检查。OSATS考试采用模拟实验室的形式,设有10个站点:4个腹腔镜手术技能站点和6个开放手术技能站点。培训过程进行了录像,并由资深作者使用特定任务清单进行评分。录像评分由2名资深作者在不知道其他考官结果的情况下进行。考试进行了录像,参与者的身份进行了保密。每个站点的分数是通过将技能评分的所有数字与时间分数相加来确定的。分数越高表示表现越好。采用非参数检验(Kruskal-Wallis)进行统计分析,将住院医师分为初级住院医师(第一年和第二年)、高级住院医师(第三年和第四年),以教员身份作为自变量计算总分。为了确定两个分数之间的相互关联可靠性,使用了肯德尔tau beta统计量。

结果

结果显示7个站点有明确的趋势,初级住院医师表现最差,教员表现最好。这一趋势在10个站点中的6个站点具有统计学意义。

结论

OSATS考试具有良好的结构效度,其效度范围不仅适用于住院医师,也适用于教员。

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