Kubota Yoshie, Yano Yoshitaka, Morimoto Takeshi, Seki Susumu, Takada Kaori, Kuramoto Nobuo, Maeda Yuko, Akaike Akinori, Hiraide Atsushi
Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, Japan.
Yakugaku Zasshi. 2009 May;129(5):609-16. doi: 10.1248/yakushi.129.609.
In the objective structured clinical examination (OSCE), which for pharmaceutical students training, adequate methods should be used for evaluating a student's skill and aptitude for good communication in a medical interview. However, the reliability of the evaluation methods used in the pharmaceutical OSCE has not been investigated sufficiently. In this study, we reviewed the evaluation scores and video recordings obtained in a pharmaceutical OSCE trial, and examined the reasons for disagreement in the scores between two raters. We had two experienced raters in medical communication re-evaluate the students using the vide images, and compared their scores with those on the examination day. The ratio of disagreement was 14.5% (87/600 items in 30 students), and the reason for disagreement could not be identified for 63 items that evaluated communication skills such as 'actively listen' and 'empathy'. A comparison of the scores on examination day and those on re-evaluation revealed a possible reason for the disagreement; the use of a checklist, i.e. binary scores, with criteria that differed between the raters. We suggest that the items used for a detailed performance evaluation be selected carefully and that rating scales be used in order to perform an adequate evaluation, especially regarding communication skill and aptitude.
在用于药学专业学生培训的客观结构化临床考试（OSCE）中，应采用适当方法评估学生在医学问诊中良好沟通的技能和能力。然而，药学OSCE中所使用评估方法的可靠性尚未得到充分研究。在本研究中，我们回顾了药学OSCE试验中获得的评估分数和录像，并检查了两位评分者之间分数不一致的原因。我们让两位有医学沟通经验的评分者使用视频图像对学生进行重新评估，并将他们的分数与考试当天的分数进行比较。不一致率为14.5%（30名学生的600项中有87项），对于评估“积极倾听”和“同理心”等沟通技能的63项，无法确定不一致的原因。考试当天分数与重新评估分数的比较揭示了不一致的一个可能原因；使用了清单，即二分制分数，评分者之间的标准不同。我们建议仔细选择用于详细表现评估的项目，并使用评分量表以进行充分评估，特别是在沟通技能和能力方面。
