采用剧本一致性测试评估妇科手术中的术中判断。

Assessment of intraoperative judgment during gynecologic surgery using the Script Concordance Test.

机构信息

Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH, USA.

出版信息

Am J Obstet Gynecol. 2010 Sep;203(3):240.e1-6. doi: 10.1016/j.ajog.2010.04.010. Epub 2010 May 21.

DOI:10.1016/j.ajog.2010.04.010

PMID:20494330

Abstract

OBJECTIVE

We sought to develop a valid, reliable assessment of intraoperative judgment by residents during gynecologic surgery based on Script Concordance Theory.

STUDY DESIGN

This was a multicenter prospective study involving 5 obstetrics and gynecology residency programs. Surgeons from each site generated case scenarios based on common gynecologic procedures. Construct validity was evaluated by correlating scores to training level, in-service examinations, and surgical skill and experience using a Global Rating Scale of Operative Performance and case volumes.

RESULTS

A final test that included 42 case scenarios was administered to 75 residents. Internal consistency (Cronbach alpha = 0.73) and test-retest reliability (Lin correlation coefficient = 0.76) were good. There were significant differences between test scores and training levels (P = .002) and test scores correlated with in-service examination scores (r = 0.38; P = .001). There was no association between test scores and total number of cases or technical skills.

CONCLUSION

The Script Concordance Test appears to be a reliable, valid assessment tool for intraoperative decision-making during gynecologic surgery.

摘要

目的

我们旨在基于脚本一致性理论，为妇科手术中的住院医师的术中判断开发一种有效且可靠的评估方法。

研究设计

这是一项涉及 5 个妇产科住院医师培训项目的多中心前瞻性研究。每个地点的外科医生根据常见的妇科手术生成病例场景。通过使用手术操作表现的整体评分和病例量的全球评分量表，将评分与培训水平、在职考试和手术技能与经验相关联，对构念效度进行评估。

结果

对 75 名住院医师进行了最终包含 42 个病例场景的测试。内部一致性（Cronbach alpha = 0.73）和测试-重测信度（Lin 相关系数 = 0.76）良好。测试分数与培训水平之间存在显著差异（P =.002），并且测试分数与在职考试分数相关（r = 0.38；P =.001）。测试分数与病例总数或技术技能之间没有关联。