Emory University School of Medicine, Department of Emergency Medicine, Atlanta, GA.
West J Emerg Med. 2010 Dec;11(5):500-5.
To use 360-degree evaluations within an Observed Structured Clinical Examination (OSCE) to assess medical student comfort level and communication skills with intimate partner violence (IPV) patients.
We assessed a cohort of fourth year medical students' performance using an IPV standardized patient (SP) encounter in an OSCE. Blinded pre- and post-tests determined the students' knowledge and comfort level with core IPV assessment. Students, SPs and investigators completed a 360-degree evaluation that focused on each student's communication and competency skills. We computed frequencies, means and correlations.
Forty-one students participated in the SP exercise during three separate evaluation periods. Results noted insignificant increase in students' comfort level pre-test (2.7) and post-test (2.9). Although 88% of students screened for IPV and 98% asked about the injury, only 39% asked about verbal abuse, 17% asked if the patient had a safety plan, and 13% communicated to the patient that IPV is illegal. Using Likert scoring on the competency and overall evaluation (1, very poor and 5, very good), the mean score for each evaluator was 4.1 (competency) and 3.7 (overall). The correlations between trainee comfort level and the specific competencies of patient care, communication skill and professionalism were positive and significant (p<0.05).
Students felt somewhat comfortable caring for patients with IPV. OSCEs with SPs can be used to assess student competencies in caring for patients with IPV.
在观察性结构临床考试(OSCE)中使用 360 度评估来评估医学生与亲密伴侣暴力(IPV)患者的舒适度和沟通技巧。
我们使用 OSCE 中的 IPV 标准化患者(SP)遭遇来评估一组四年级医学生的表现。盲法预测试和后测试确定了学生对核心 IPV 评估的知识和舒适度。学生、SP 和调查员完成了一项 360 度评估,重点关注每个学生的沟通和能力技能。我们计算了频率、平均值和相关性。
41 名学生在三个单独的评估期内参加了 SP 练习。结果表明,学生的舒适度在预测试(2.7)和后测试(2.9)中没有显著增加。尽管 88%的学生对 IPV 进行了筛查,98%的学生询问了伤害情况,但只有 39%的学生询问了言语虐待,17%的学生询问了患者是否有安全计划,13%的学生向患者传达了 IPV 是非法的。使用 1 分(非常差)和 5 分(非常好)的李克特评分,每位评估者的平均得分为 4.1(能力)和 3.7(整体)。培训师的舒适度与患者护理、沟通技巧和专业精神等特定能力之间的相关性呈正相关且具有统计学意义(p<0.05)。
学生在照顾 IPV 患者方面感到有些舒适。使用 SP 的 OSCE 可用于评估学生照顾 IPV 患者的能力。