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优化沟通 OSCE 的实用性:省略特定站点的检查表并为学生提供叙述性反馈。

Optimizing the utility of communication OSCEs: omit station-specific checklists and provide students with narrative feedback.

机构信息

Department of General Practice, Catholic University of Leuven, Leuven, Belgium.

出版信息

Patient Educ Couns. 2012 Jul;88(1):106-12. doi: 10.1016/j.pec.2011.12.015. Epub 2012 Feb 10.

Abstract

OBJECTIVE

To evaluate how the utility (reliability, validity, acceptability, feasibility, cost and educational impact) of a communication-OSCE was influenced by whether or not station-specific (StSp) checklists were used together with a generic instrument and whether or not narrative feedback was provided to students.

METHODS

At ten stations, faculty members rated standardized patient-student interactions using the common ground (CG) instrument (at all stations) and StSp-checklists. Both raters and patients provided written feedback. The impact of changing the design on the various utility parameters was assessed: reliability by means of a generalizability study, cost using the Reznick model and the other utility parameters by means of a survey.

RESULTS

Use of the generic instrument (CG) proved more reliable (G coefficient=0.67) than using the StSp-checklists (G=0.47) or both (G=0.65) while there was a high correlation between both scale scores (Pearsons'r=0.86). The cost was 6.5% higher when StSp-checklists were used and 5% higher when narrative feedback was provided.

CONCLUSION

The utility of a communication OSCE can be enhanced by omitting StSp-checklists and by providing narrative feedback to students.

PRACTICE IMPLICATIONS

The same generic assessment scale can be used in all stations of a communication OSCE. Providing feedback to students is promising but it increases the costs.

摘要

目的

评估在使用或不使用特定于站点(StSp)清单的情况下,与通用仪器一起使用以及是否为学生提供叙述性反馈,对沟通 OSCE 的实用性(可靠性、有效性、可接受性、可行性、成本和教育影响)有何影响。

方法

在十个站点,教职员工使用通用(CG)工具(在所有站点)和 StSp-清单对标准化患者-学生互动进行评估。评估改变设计对各种实用参数的影响:使用概化研究评估可靠性,使用 Reznick 模型评估成本,使用调查评估其他实用参数。

结果

使用通用仪器(CG)比使用 StSp-清单(G=0.47)或同时使用两者(G=0.65)更可靠(G 系数=0.67),而两个量表得分之间存在高度相关性(Pearsons'r=0.86)。当使用 StSp-清单时,成本增加 6.5%,当提供叙述性反馈时,成本增加 5%。

结论

通过省略 StSp-清单并为学生提供叙述性反馈,可以提高沟通 OSCE 的实用性。

实践意义

可以在沟通 OSCE 的所有站点使用相同的通用评估量表。为学生提供反馈很有希望,但会增加成本。

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