Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Med Teach. 2012;34(1):30-7. doi: 10.3109/0142159X.2011.590557.
Developing feasible, reliable and valid methods for the evaluation of clinical reasoning is challenging.
To explore feasibility, reliability, and validity evidence for a post-encounter form assessing clinical reasoning.
A free-text, post-encounter form was used in an Objective Structured Clinical Examination (OSCE) station to assess clinical reasoning for end-of-second-year medical students. Feasibility was assessed by time to complete form. Inter-rater reliability was assessed by kappa. Validity evidence was obtained by comparing scores from individual items on the post-encounter form and other components in this OSCE station (i.e., standardized patient checklist and oral presentation rating form). Additional validity evidence was gathered by comparing scores on this station with other course performance graded events.
Feasibility and estimated reliability were high, and several lines of validity evidence were supported.
The scores from an end-of-second-year, medical school, post-encounter form yielded adequate psychometric properties and can be used for the evaluation of clinical reasoning. Moreover, this form of assessment and its scoring could translate to other venues.
开发可行、可靠和有效的临床推理评估方法具有挑战性。
探索用于评估临床推理的事后表格的可行性、可靠性和有效性证据。
在客观结构化临床考试 (OSCE) 站的一个无格式、事后表格中使用了一种方法,以评估第二年医学生结束时的临床推理。通过完成表格的时间来评估可行性。通过kappa 评估评分者间可靠性。通过比较事后表格上的各个项目的分数和该 OSCE 站的其他组成部分(即标准化患者检查表和口头报告评分表)来获得有效性证据。通过将该站的分数与其他课程表现分级事件进行比较来收集额外的有效性证据。
可行性和估计可靠性都很高,并且得到了几条有效性证据的支持。
第二年医学校结束时的事后表格的分数具有足够的心理测量学特性,可以用于评估临床推理。此外,这种评估形式及其评分可以转化到其他场所。