Ringsted C, Lippert F, Hesselfeldt R, Rasmussen M B, Mogensen S S, Frost T, Jensen M L, Jensen M K, Van der Vleuten C
Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Resuscitation. 2007 Oct;75(1):153-60. doi: 10.1016/j.resuscitation.2007.03.003. Epub 2007 Apr 30.
Robust assessment of Advanced Life Support (ALS) competence is paramount to the credibility of ALS-provider certification and for estimating the learning outcome and retention of ALS competence following the courses. The European Resuscitation Council (ERC) provides two sets of MCQs and four Cardiac Arrest Simulation Test (CASTest) scenarios for the assessments according to guidelines 2005.
To analyse the reliability and validity of the individual sub-tests provided by ERC and to find a combination of MCQ and CASTest that provides a reliable and valid single effect measure of ALS competence.
Two groups of participants were included in this randomised, controlled experimental study: a group of newly graduated doctors, who had not taken the ALS course (N=17) and a group of students, who had passed the ALS course 9 months before the study (N=16). Reliability in terms of inter-rater agreement and generalisability across skills scenarios were estimated. Validity was studied in terms of equality of test difficulty and ability to discriminate performance between the groups.
Inter-rater agreement on checklist scores were generally high, Intraclass Correlation Coefficients between 0.766 and 0.977. Inter-rater agreements on pass/fail decisions were not perfect. The one MCQ test was significantly more difficult than the other. There were no significant differences between CASTests. Generalisability theory was use to identify a composite of MCQ and CASTest scenarios that possessed high reliability, equality of test sets, and ability to discriminate between the two groups of supposedly different ALS competence.
ERC sub-tests of ALS competence possess sufficient reliability and validity. A combined ALS score with equal weighting of one MCQ and one CASTest can be used as a single measurement of ALS competence.
对高级生命支持（ALS）能力进行可靠评估对于ALS提供者认证的可信度以及评估课程后ALS能力的学习成果和保持情况至关重要。欧洲复苏委员会（ERC）根据2005年指南提供了两组多项选择题和四个心脏骤停模拟测试（CASTest）场景用于评估。
分析ERC提供的各个子测试的可靠性和有效性，并找到一种多项选择题和CASTest的组合，以提供可靠且有效的ALS能力单一效果测量方法。
两组参与者被纳入这项随机对照实验研究：一组是刚毕业且未参加过ALS课程的医生（N = 17），另一组是在研究前9个月通过ALS课程的学生（N = 16）。评估了评分者间一致性方面的可靠性以及跨技能场景的通用性。从测试难度的平等性和区分两组表现的能力方面研究了有效性。
评分者间在检查表分数上的一致性普遍较高，组内相关系数在0.766至0.977之间。评分者间在通过/失败判定上的一致性并不完美。一项多项选择题测试比另一项明显更难。CASTest之间没有显著差异。运用通用izability理论来确定多项选择题和CASTest场景的组合，该组合具有高可靠性、测试集的平等性以及区分两组假定不同ALS能力的能力。
ERC的ALS能力子测试具有足够的可靠性和有效性。一项多项选择题和一项CASTest权重相等的综合ALS分数可作为ALS能力的单一测量指标。
