Vivekananda-Schmidt Pirashanthie, Lewis Martyn, Hassell Andrew B, Coady David, Walker David, Kay Lesley, McLean Monica J, Haq Inam, Rahman Anisur
Primary Care Sciences Research Centre, Keele University, Keele, UK.
Med Educ. 2007 Apr;41(4):402-10. doi: 10.1111/j.1365-2929.2007.02712.x.
Self-assessment promotes reflective practice, helps students identify gaps in their learning and is used in curricular evaluations. Currently, there is a dearth of validated self-assessment tools in rheumatology. We present a new musculoskeletal self-assessment tool (MSAT) that allows students to assess their confidence in their skills in and knowledge of knee and shoulder examination.
We aimed to validate the 15-item MSAT, addressing its construct validity, internal consistency, responsiveness, repeatability and relationship with competence.
Participants were 241 Year 3 students in Newcastle upon Tyne and 113 Year 3 students at University College London, who were starting their musculoskeletal skills placement. Factor analysis explored the construct validity of the MSAT; Cronbach's alpha assessed its internal consistency; standardised response mean (SRM) evaluated its responsiveness, and test-retest, before and after a pathology lecture, assessed its repeatability. Its relationship with competence was explored by evaluating its correlation with shoulder and knee objective structured clinical examinations (OSCEs). Results The MSAT was valid in distinguishing the 5 domains it intended to measure: clinical examination of the knee; clinical examination of the shoulder; clinical anatomy of the knee and shoulder; history taking, and generic musculoskeletal anatomical and clinical terms. It was internally consistent (alpha = 0.93), responsive (SRM 0.6 in Newcastle and 2.2 in London) and repeatable (intraclass correlation coefficient 0.97). Correlations between MSAT scores and OSCE scores were weak (r < 0.2).
The MSAT has strong psychometric properties, thereby offering a valid approach to evaluating the self-assessment of confidence in examination skills by students. Confidence does not necessarily reflect competence; future research should clarify what underpins confidence.
自我评估有助于促进反思性实践，帮助学生识别学习中的差距，并用于课程评估。目前，风湿病学领域缺乏经过验证的自我评估工具。我们提出了一种新的肌肉骨骼自我评估工具（MSAT），该工具可让学生评估自己对膝盖和肩部检查技能及知识的信心。
我们旨在验证包含15个条目的MSAT，评估其结构效度、内部一致性、反应性、可重复性以及与能力的关系。
参与者为纽卡斯尔大学的241名三年级学生和伦敦大学学院的113名三年级学生，他们即将开始肌肉骨骼技能实习。因子分析探讨MSAT的结构效度；Cronbach's alpha评估其内部一致性；标准化反应均值（SRM）评估其反应性，病理讲座前后的重测评估其可重复性。通过评估其与肩部和膝盖客观结构化临床考试（OSCE）的相关性，探讨其与能力的关系。结果MSAT在区分其旨在测量的5个领域方面是有效的：膝盖临床检查；肩部临床检查；膝盖和肩部临床解剖学；病史采集，以及一般肌肉骨骼解剖学和临床术语。它具有内部一致性（α = 0.93）、反应性（纽卡斯尔地区SRM为0.6，伦敦地区为2.2）和可重复性（组内相关系数为0.97）。MSAT分数与OSCE分数之间的相关性较弱（r < 0.2）。
MSAT具有强大的心理测量特性，从而为评估学生对检查技能信心的自我评估提供了一种有效的方法。信心不一定反映能力；未来的研究应阐明信心的基础是什么。
