Davoudi Mohsen, Quadrelli Silvia, Osann Kathryn, Colt Henri G
Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of California, Irvine Medical Center, Orange, CA 92868, USA.
Respirology. 2008 Sep;13(5):736-43. doi: 10.1111/j.1440-1843.2008.01320.x.
Competency-based training and assessment are increasingly replacing the traditional structure- and process-based model of medical education. The web-based Essential Bronchoscopist (EB) is an open access, laddered, competency-based curriculum of question-answer sets pertaining to basic bronchoscopic knowledge, accessible in five languages. The purpose of this study was to use consensus to evaluate whether question-answer sets (items) from the EB could provide material from which to devise competency-based tests of bronchoscopic knowledge that could be used in countries with different health-care environments.
Ten junior and five senior bronchoscopists in Argentina and the USA were asked to identify the material in each of the 186 items of the EB as either 'not necessary', 'necessary' or 'absolutely necessary' for inclusion in a competency-based test of bronchoscopic knowledge. The kappa statistic was used to analyse inter-rater agreement.
More than 80% of the 30 participants rated 150 of 186 items as necessary or absolutely necessary. Seventy items were rated as absolutely necessary by more than 50% of participants and as necessary or absolutely necessary by more than 90%. There was no statistically significant difference between items selected, based on level of training or environment of practice.
Consensus among junior and senior bronchoscopists from two culturally different health-care environments demonstrated that question-answer sets from the EB can be used to provide material for competency-based tests of bronchoscopic knowledge.
基于胜任力的培训与评估正日益取代传统的基于结构和过程的医学教育模式。基于网络的基础支气管镜医师课程（EB）是一个开放获取、分层的、基于胜任力的问答集课程，涉及基础支气管镜知识，有五种语言版本可供使用。本研究的目的是通过达成共识来评估EB中的问答集（题目）能否为设计基于胜任力的支气管镜知识测试提供素材，这些测试可用于不同医疗环境的国家。
邀请阿根廷和美国的10名初级支气管镜医师和5名高级支气管镜医师，将EB的186个题目中的每一个题目所涉及的素材判定为对于纳入基于胜任力的支气管镜知识测试是“不必要”“必要”还是“绝对必要”。kappa统计量用于分析评分者间的一致性。
30名参与者中超过80%将186个题目中的150个评定为必要或绝对必要。70个题目被超过50%的参与者评定为绝对必要，被超过90%的参与者评定为必要或绝对必要。根据培训水平或实践环境选择的题目之间无统计学显著差异。
来自两个文化背景不同的医疗环境中的初级和高级支气管镜医师达成的共识表明，EB中的问答集可用于为基于胜任力的支气管镜知识测试提供素材。
