Lie Desiree, Boker John, Bereknyei Sylvia, Ahearn Susan, Fesko Charlotte, Lenahan Patricia
University of California, Irvine School of Medicine, Irvine, CA, USA.
J Gen Intern Med. 2007 Nov;22 Suppl 2(Suppl 2):336-40. doi: 10.1007/s11606-007-0349-3.
Increasing prevalence of limited English proficiency patient encounters demands effective use of interpreters. Validated measures for this skill are needed.
We describe the process of creating and validating two new measures for rating student skills for interpreter use.
Encounters using standardized patients (SPs) and interpreters within a clinical practice examination (CPX) at one medical school.
Students were assessed by SPs using the interpreter impact rating scale (IIRS) and the physician patient interaction (PPI) scale. A subset of 23 encounters was assessed by 4 faculty raters using the faculty observer rating scale (FORS). Internal consistency reliability was assessed by Cronbach's coefficient alpha (alpha). Interrater reliability of the FORS was examined by the intraclass correlation coefficient (ICC). The FORS and IIRS were compared and each was correlated with the PPI.
Cronbach's alpha was 0.90 for the 7-item IIRS and 0.88 for the 11-item FORS. ICC among 4 faculty observers had a mean of 0.61 and median of 0.65 (0.20, 0.86). Skill measured by the IIRS did not significantly correlate with FORS but correlated with the PPI.
We developed two measures with good internal reliability for use by SPs and faculty observers. More research is needed to clarify the reasons for the lack of concordance between these measures and which may be more valid for use as a summative assessment measure.
英语水平有限的患者就医情况日益普遍，这就需要有效地使用口译员。因此需要有经过验证的衡量该技能的方法。
我们描述了创建和验证两种用于评估学生使用口译员技能的新方法的过程。
在一所医学院的临床实践考试（CPX）中，使用标准化患者（SP）和口译员进行诊疗。
由标准化患者使用口译员影响评定量表（IIRS）和医患互动（PPI）量表对学生进行评估。4名教员评分员使用教员观察评定量表（FORS）对23次诊疗的一个子集进行评估。通过克朗巴赫系数α（α）评估内部一致性信度。通过组内相关系数（ICC）检验FORS的评分者间信度。比较FORS和IIRS，并将它们各自与PPI进行相关性分析。
7项IIRS的克朗巴赫α系数为0.90，11项FORS的克朗巴赫α系数为-0.88。4名教员观察者之间的ICC均值为0.61，中位数为0.65（0.20，0.86）。IIRS所衡量的技能与FORS没有显著相关性，但与PPI相关。
我们开发了两种具有良好内部信度的方法，供标准化患者和教员观察者使用。需要更多的研究来阐明这些方法之间缺乏一致性的原因，以及哪种方法可能更适合用作总结性评估方法。
