Department of Internal Medicine, University of Illinois at Chicago, Chicago, Illinois 60612, USA.
Acad Med. 2012 Oct;87(10):1408-12. doi: 10.1097/ACM.0b013e3182677944.
Consultation evaluation tools with strong validity evidence are scarce. The goal of this study was to demonstrate evidence of the validity of a new checklist, the 5Cs model (contact, communicate, core question, collaboration, and closing the loop), used to assess simulated emergent telephone consultations between residents and attending physician consultants.
The authors developed items for the checklist based on a theoretical model, and content experts constructed two simulated emergent cases (one psychiatric and one surgical). In 2010, residents conducted consultations on the two cases by telephone with a standardized physician consultant, and three clinical faculty members rated the residents' consultations using the checklist. The authors analyzed the residents' checklist scores for response process validity, internal structure validity, and validity concerning the relationship to other variables.
The authors established the checklist's content validity through its development based on a theoretical model, literature, and expert input. Response process validity evidence includes interrater reliability based on an intraclass correlation of 0.94. Internal structure validity evidence includes a generalizability analysis yielding a phi coefficient of 0.89 with three raters across two cases and a decision study yielding a phi coefficient of 0.8 with a single rater and three cases. Relationship to other variables includes correlations of 0.59 and 0.79 between mean scores on a global rating scale and on the checklist for the two simulated cases.
Multiple sources of validity evidence support the use of the 5Cs model as a tool to assess telephone consultations.
具有较强有效性证据的咨询评估工具较为缺乏。本研究旨在证明一种新的检查表（5Cs 模型，即联系、沟通、核心问题、协作和循环）的有效性证据，该检查表用于评估住院医师与主治医生顾问之间进行的模拟紧急电话咨询。
作者基于理论模型制定了检查表的项目，并由内容专家构建了两个模拟紧急案例（一个是精神科案例，一个是外科案例）。2010 年，住院医师通过电话与标准化医师顾问进行了两次案例咨询，由三位临床教师使用检查表对住院医师的咨询进行评分。作者分析了住院医师检查表的得分，以确定其在反应过程有效性、内部结构有效性和与其他变量关系方面的有效性。
作者通过基于理论模型、文献和专家意见的检查表制定过程，确立了其内容有效性。反应过程有效性的证据包括基于 0.94 的组内相关系数的评分者间可靠性。内部结构有效性的证据包括在两个案例中使用三个评分者进行的一般化分析，得到的 phi 系数为 0.89，以及使用单个评分者和三个案例进行的决策研究，得到的 phi 系数为 0.8。与其他变量的关系包括两个模拟案例的整体评分和检查表的平均得分之间的 0.59 和 0.79 的相关性。
多种有效性证据支持使用 5Cs 模型作为评估电话咨询的工具。
