会阴Ⅳ度裂伤修复技术技能的客观结构化评估
Objective structured assessment of technical skills for repair of fourth-degree perineal lacerations.
作者信息
Siddiqui Nazema Y, Stepp Kevin J, Lasch Susan J, Mangel Jeffrey M, Wu Jennifer M
机构信息
Division of Urogynecology and Reconstructive Pelvic Surgery, Duke University Medical Center, Durham, NC, USA.
出版信息
Am J Obstet Gynecol. 2008 Dec;199(6):676.e1-6. doi: 10.1016/j.ajog.2008.07.054.
OBJECTIVE
The objective of this study was to assess the reliability and validity of an objective structured assessment of technical skills (OSATS) for repair of fourth-degree obstetric lacerations on a surgical model.
STUDY DESIGN
Three blinded judges reviewed recordings of 20 junior and 20 senior obstetrics-gynecology residents performing simulated perineal repairs using a beef tongue model. Judges completed task-specific OSATS and global rating scales for each repair. Six recordings were rereviewed after 2 weeks. Inter- and intrarater reliability and construct validity were assessed.
RESULTS
Interrater reliability was 0.80 for task-specific OSATS and 0.59 for the global rating scale. Intrarater reliability was poor. Construct validity was demonstrated, with senior residents scoring higher than junior residents on task-specific OSATS (13.0 vs 10.5; P = .007) and the global rating scale (24.0 vs 19.3; P = .001).
CONCLUSION
We found good interrater reliability and construct validity using a task-specific OSATS for fourth-degree perineal laceration repair. This instrument shows promise as a tool for competency-based evaluations.
目的
本研究的目的是评估在手术模型上对四度产科裂伤修复进行客观结构化技术技能评估（OSATS）的可靠性和有效性。
研究设计
三名盲法评委审查了20名初级和20名高级妇产科住院医师使用牛舌模型进行模拟会阴修复的录像。评委为每次修复完成特定任务的OSATS和整体评分量表。两周后重新审查了六段录像。评估了评分者间和评分者内的可靠性以及结构效度。
结果
特定任务的OSATS评分者间可靠性为0.80，整体评分量表为0.59。评分者内可靠性较差。证实了结构效度，高级住院医师在特定任务的OSATS（13.0对10.5；P = .007）和整体评分量表（24.0对19.3；P = .001）上的得分高于初级住院医师。
结论
我们发现使用特定任务的OSATS对四度会阴裂伤修复具有良好的评分者间可靠性和结构效度。该工具显示出作为基于能力评估工具的潜力。
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