Lockyer Jocelyn M, Violato Claudio, Fidler Herta
Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
Acad Emerg Med. 2006 Dec;13(12):1296-303. doi: 10.1197/j.aem.2006.07.030. Epub 2006 Nov 10.
To determine whether it is possible to develop a feasible, valid, and reliable multisource feedback program (360 degree evaluation) for emergency physicians.
Surveys with 16, 20, 30, and 31 items were developed to assess emergency physicians by 25 patients, eight coworkers, eight medical colleagues, and self, respectively, using five-point scales along with an "unable to assess" category. Items addressed key competencies related to communication skills, professionalism, collegiality, and self-management.
Data from 187 physicians who identified themselves as emergency physicians were available. The mean number of respondents per physician was 21.6 (SD +/- 3.87) (93%) for patients, 7.6 (SD +/- 0.89) (96%) for coworkers, and 7.7 (SD +/- 0.61) (95%) for medical colleagues, suggesting it was a feasible tool. Only the patient survey had four items with "unable to assess" percentages > or = 15%. The factor analysis indicated there were two factors on the patient questionnaire (communication/professionalism and patient education), two on the coworker survey (communication/collegiality and professionalism), and four on the medical colleague questionnaire (clinical performance, professionalism, self-management, and record management) that accounted for 80.0%, 62.5%, and 71.9% of the variance on the surveys, respectively. The factors were consistent with the intent of the instruments, providing empirical evidence of validity for the instruments. Reliability was established for the instruments (Cronbach's alpha > 0.94) and for each physician (generalizability coefficients were 0.68 for patients, 0.85 for coworkers, and 0.84 for medical colleagues).
The psychometric examination of the data suggests that the instruments developed to assess emergency physicians were feasible and provide evidence for validity and reliability.
确定是否有可能为急诊医师开发一个可行、有效且可靠的多源反馈项目（360度评估）。
分别设计了包含16项、20项、30项和31项的调查问卷，由25名患者、8名同事、8名医学同行以及医师本人使用五点量表并设置“无法评估”类别来对急诊医师进行评估。问卷项目涉及与沟通技巧、专业素养、团队合作及自我管理相关的关键能力。
获取了187名自认为是急诊医师的医生的数据。每位医师的患者平均回复人数为21.6（标准差±3.87）（93%），同事平均回复人数为7.6（标准差±0.89）（96%），医学同行平均回复人数为7.7（标准差±0.61）（95%），表明这是一个可行的工具。只有患者调查问卷中有4项“无法评估”的比例≥15%。因子分析表明，患者问卷上有两个因子（沟通/专业素养和患者教育），同事调查问卷上有两个因子（沟通/团队合作和专业素养），医学同行调查问卷上有四个因子（临床绩效、专业素养、自我管理和记录管理），分别占调查问卷方差的80.0%、62.5%和71.9%。这些因子与工具的意图一致，为工具的有效性提供了实证证据。确定了工具的信度（克朗巴哈系数>0.94）以及每位医师的信度（患者的概化系数为0.68，同事为0.85，医学同行0.84）。
对数据的心理测量学检验表明，为评估急诊医师而开发的工具是可行的，并为有效性和可靠性提供了证据。
