Vanderbilt Voice Center, Departments of Otolaryngology and Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA.
J Voice. 2012 May;26(3):358-64. doi: 10.1016/j.jvoice.2011.07.006. Epub 2011 Oct 22.
To determine how standard residency training and educational background affect otolaryngology resident auditory-perceptual judgments compared with inexperienced listeners. A secondary aim was to assess the impact of a brief training session on the reliability of judgments among otolaryngology residents.
Mixed cross-sectional and cohort study.
Twenty adult dysphonic and four normal speaker samples were selected from a database. Fifteen listeners at various stages of residency in otolaryngology judged all samples for breathiness and roughness using visual analog scales. Fifteen inexperienced listeners judged the same samples. Subsequently, 12 otolaryngology residents underwent a brief training session. During training, listeners were provided definitions of rating dimensions and accuracy feedback while rating 20 novel (training) stimuli. The feedback included averaged responses from experienced clinicians who had previously evaluated the same speech samples. The residents then completed posttraining evaluations.
As a group, otolaryngology resident listeners had significantly better interrater agreement for judgments of roughness compared with inexperienced listeners (P<0.05) and trended toward better interrater agreement for judgments of breathiness (P=0.058). Posttraining, no significant improvement in interrater agreement for judgments of roughness was observed; however, a significant improvement was found in interrater agreement of judgments of breathiness (P<0.05).
Compared with inexperienced (untrained) listeners, otolaryngology resident listeners had better interrater agreement overall for judgments of dysphonia. A short training module was associated with improved reliability in resident evaluation of breathiness. Results have implications for improving and standardizing resident evaluation of dysphonia.
确定标准住院医师培训和教育背景如何影响耳鼻喉科住院医师的听觉感知判断，与无经验的听众相比。次要目的是评估简短培训课程对耳鼻喉科住院医师判断可靠性的影响。
混合横断面和队列研究。
从数据库中选择了 20 名成人发音困难和 4 名正常发音者样本。 15 名处于耳鼻喉科住院医师各个阶段的听众使用视觉模拟量表对所有样本的呼吸音和粗糙度进行判断。 15 名无经验的听众判断了相同的样本。随后，12 名耳鼻喉科住院医师参加了一个简短的培训课程。在培训过程中，听众在对 20 个新（培训）刺激进行评分时，提供了评分维度的定义和准确性反馈。反馈包括对先前评估过相同语音样本的经验丰富的临床医生的平均反应。然后，住院医师完成了培训后的评估。
作为一个群体，耳鼻喉科住院医师听众在判断粗糙度方面的组内评分者间一致性明显优于无经验听众（P<0.05），并且在判断呼吸音方面的评分者间一致性也有所提高（P=0.058）。培训后，判断粗糙度的评分者间一致性没有显著提高；然而，在判断呼吸音方面的评分者间一致性显著提高（P<0.05）。
与无经验（未经培训）的听众相比，耳鼻喉科住院医师听众对发音困难的总体判断具有更好的评分者间一致性。简短的培训模块与住院医师对呼吸音评估的可靠性提高有关。结果对改善和标准化住院医师对发音困难的评估具有影响。
