Perkins Gavin D, Davies Robin P, Stallard Nigel, Bullock Ian, Stevens Harry, Lockey Andrew
Warwick Medical School, University of Warwick, Warwick CV4 4AL, United Kingdom.
Resuscitation. 2007 Dec;75(3):484-90. doi: 10.1016/j.resuscitation.2007.05.020. Epub 2007 Jul 13.
The cardiac arrest scenario test (CASTest) is a central component of the assessment strategy on the Advanced Life Support Course. The aim of this study was to establish equivalence between the four different CASTest scenarios and investigate the impact of profession, candidate order and course centre on the pass rate.
This was a cluster randomised study. CASTest scenarios were randomly allocated to candidates stratified by course centre. Candidate demographics and performance were recorded on the criterion referenced check list along with the final assessment outcome (pass/fail). Differences in pass rates according scenario; profession, course centre and candidate order were examined by Chi-squared and multiple logistic regression.
Two thousand, four hundred and forty-nine assessments from 65 course centres were evaluated. There was no difference in pass rate between scenarios (average pass rate 74.4%). Pass rates according to course centre varied widely (40-93%, P<0.0001) as did professional group (42-100%, P<0.0001). The order that candidates took the test did not influence the pass rate.
The CASTest assessment scenarios used during ALS testing appear equivalent in terms of difficulty. In contrast, the professional background of the candidate and centre at which the assessment is performed do significantly influence the likelihood of passing the assessment. Further evaluation of the reasons for differences between course centres is required.
心脏骤停情景测试（CASTest）是高级生命支持课程评估策略的核心组成部分。本研究的目的是确定四种不同的CASTest情景之间的等效性，并调查专业、考生顺序和课程中心对通过率的影响。
这是一项整群随机研究。CASTest情景被随机分配给按课程中心分层的考生。在标准参考检查表上记录考生的人口统计学信息和表现以及最终评估结果（通过/未通过）。通过卡方检验和多元逻辑回归分析按情景、专业、课程中心和考生顺序划分的通过率差异。
对来自65个课程中心的2449次评估进行了分析。各情景之间的通过率没有差异（平均通过率74.4%）。不同课程中心的通过率差异很大（40%-93%，P<0.0001），不同专业组的通过率也是如此（42%-100%，P<0.0001）。考生参加考试的顺序不影响通过率。
在高级生命支持测试中使用的CASTest评估情景在难度方面似乎是等效的。相比之下，考生的专业背景和进行评估的中心确实会显著影响通过评估的可能性。需要进一步评估课程中心之间存在差异的原因。
