Division of Emergency Medicine, Children's Hospital Boston, Boston, MA 02115, USA.
Simul Healthc. 2012 Oct;7(5):288-94. doi: 10.1097/SIH.0b013e3182620228.
This study examined the reliability of the scores of an assessment instrument, the Debriefing Assessment for Simulation in Healthcare (DASH), in evaluating the quality of health care simulation debriefings. The secondary objective was to evaluate whether the instrument's scores demonstrate evidence of validity.
Two aspects of reliability were examined, interrater reliability and internal consistency. To assess interrater reliability, intraclass correlations were calculated for 114 simulation instructors enrolled in webinar training courses in the use of the DASH. The instructors reviewed a series of 3 standardized debriefing sessions. To assess internal consistency, Cronbach α was calculated for this cohort. Finally, 1 measure of validity was examined by comparing the scores across 3 debriefings of different quality.
Intraclass correlation coefficients for the individual elements were predominantly greater than 0.6. The overall intraclass correlation coefficient for the combined elements was 0.74. Cronbach α was 0.89 across the webinar raters. There were statistically significant differences among the ratings for the 3 standardized debriefings (P < 0.001).
The DASH scores showed evidence of good reliability and preliminary evidence of validity. Additional work will be needed to assess the generalizability of the DASH based on the psychometrics of DASH data from other settings.
本研究旨在检验评估工具 Debriefing Assessment for Simulation in Healthcare（DASH）评分在评估医疗模拟情景后反馈质量方面的可靠性。本研究的次要目标是评估该工具的评分是否具有有效性的证据。
本研究检验了可靠性的两个方面，即评分者间信度和内部一致性。为了评估评分者间信度，对参加了使用 DASH 的网络研讨会培训课程的 114 名模拟教学人员进行了计算，评估了他们对 3 次标准化反馈情景的评分。为了评估内部一致性，对该组计算了 Cronbach α。最后，通过比较 3 次不同质量的反馈情景的评分，检验了 1 种有效性测量方法。
各个元素的组内相关系数主要大于 0.6。综合元素的总体组内相关系数为 0.74。网络研讨会评分者的 Cronbach α 为 0.89。3 次标准化反馈情景的评分存在统计学差异（P<0.001）。
DASH 评分具有良好的可靠性和初步有效性的证据。需要进一步研究基于其他情境的 DASH 数据的心理计量学来评估 DASH 的通用性。
