Department of Medicine, The University of Queensland, Brisbane, Australia.
Inflammopharmacology. 1999;7(2):119-30. doi: 10.1007/BF02918384.
A study was designed to assess the effects of a standardized instructional videotape on training senior medical students to acceptable levels of reliability in performing several commonly used observer dependent outcome measures in patients with fibromyalgia (FM).
During a single day, six third-year medical students independently examined six patients with FM in predetermined order using a Latin Square design, before and after viewing a standardized videotape which demonstrated methods for performing doiorimelry and for delecting skinfold tenderness and reactive hyperaemia. Reliability coefficients were calculated based on the variance components of the Analysis of Variance (ANOVA) table.
Prestandardization reliability coefficients were <0.80 for 8 measures. Following standardization all reliability coefficients, but one, approximated or exceeded 0.80.
An important and beneficial effect of the standardization procedure was noted for several outcome variables. Such improvements in observer agreement have important implications for training senior medical students to perform quantitative measurement in the longitudinal management of FM patients in clinical practice. The use of a videotape to achieve this goal has obvious cost and convenience advantages compared with personal onc-on-one or small group training procedures.
本研究旨在评估标准化教学录像带对培训高年级医学生在使用几种常用的观察者依赖的纤维肌痛（FM）患者结局测量方法时达到可接受的可靠性水平的影响。
在一天内，六位三年级医学生使用拉丁方设计，在观看演示如何进行定向测量以及检测皮褶压痛和反应性充血的标准化录像带之前和之后，以预定顺序独立检查六位 FM 患者。可靠性系数基于方差分析（ANOVA）表的方差分量进行计算。
在标准化之前，8 项测量的可靠性系数<0.80。标准化后，除一项外，所有可靠性系数均接近或超过 0.80。
标准化程序对几个结局变量有重要和有益的影响。观察者一致性的这种提高对培训高年级医学生在纤维肌痛患者的临床实践中进行定量测量具有重要意义。与个人一对一或小组培训程序相比，使用录像带实现这一目标具有明显的成本和便利性优势。
