Oristrell J, Casanovas A, Jordana R, Comet R, Gil M, Oliva J C
Servicio de Medicina Interna, Corporació Sanitària i Universitària Parc Taulí, Sabadell, Barcelona, España.
Rev Clin Esp. 2012 Dec;212(11):520-37. doi: 10.1016/j.rce.2012.04.004. Epub 2012 Jun 7.
There are no simple and validated instruments for evaluating the training of specialists.
To analyze the reliability and validity of a computerized self-assessment method to quantify the acquisition of medical competences during the Internal Medicine residency program.
All residents of our department participated in the study during a period of 28 months. Twenty-two questionnaires specific for each rotation (the Computer-Book of the Internal Medicine Resident) were constructed with items (questions) corresponding to three competence domains: clinical skills competence, communication skills and teamwork. Reliability was analyzed by measuring the internal consistency of items in each competence domain using Cronbach's alpha index. Validation was performed by comparing mean scores in each competence domain between senior and junior residents. Cut-off levels of competence scores were established in order to identify the strengths and weaknesses of our training program. Finally, self-assessment values were correlated with the evaluations of the medical staff.
There was a high internal consistency of the items of clinical skills competences, communication skills and teamwork. Higher scores of clinical skills competence and communication skills, but not in those of teamwork were observed in senior residents than in junior residents. The Computer-Book of the Internal Medicine Resident identified the strengths and weaknesses of our training program. We did not observe any correlation between the results of the self- evaluations and the evaluations made by staff physicians.
The items of Computer-Book of the Internal Medicine Resident showed high internal consistency and made it possible to measure the acquisition of medical competences in a team of Internal Medicine residents. This self-assessment method should be complemented with other evaluation methods in order to assess the acquisition of medical competences by an individual resident.
目前尚无简单且经过验证的工具来评估专科医生培训情况。
分析一种计算机化自我评估方法的可靠性和有效性，以量化内科住院医师培训项目中医务能力的获得情况。
我们科室的所有住院医师在28个月期间参与了该研究。针对每个轮转阶段编制了22份特定问卷（《内科住院医师计算机手册》），其中的条目（问题）对应三个能力领域：临床技能能力、沟通技能和团队协作。通过使用Cronbach's alpha指数测量每个能力领域条目的内部一致性来分析可靠性。通过比较高年资和低年资住院医师在每个能力领域的平均得分进行效度验证。确定能力得分的临界水平，以识别我们培训项目的优势和不足。最后，将自我评估值与医务人员的评估进行相关性分析。
临床技能能力、沟通技能和团队协作条目的内部一致性较高。高年资住院医师在临床技能能力和沟通技能方面的得分高于低年资住院医师，但团队协作方面得分无差异。《内科住院医师计算机手册》识别出了我们培训项目的优势和不足。我们未观察到自我评估结果与带教医生评估之间存在任何相关性。
《内科住院医师计算机手册》中的条目显示出较高的内部一致性，能够测量内科住院医师团队中医务能力的获得情况。这种自我评估方法应与其他评估方法相结合，以评估个体住院医师医务能力的获得情况。
