Keister Drew M, Larson Daniel, Dostal Julie, Baglia Jay
J Grad Med Educ. 2012 Jun;4(2):220-6. doi: 10.4300/JGME-D-11-00163.1.
Despite the movement toward competency-based assessment by accrediting bodies in recent years, there is no consensus on how to best assess medical competence. Direct observation is a useful tool. At the same time, a comprehensive assessment system based on direct observation has been difficult to develop.
We developed a system that translates data obtained from checklists of observed behaviors completed during educational activities, including direct observation of clinical care, into a graphic tool (the "radar graph") usable for both formative and summative assessment. Using unique, observable behaviors to evaluate levels of competency on the Dreyfus scale, we assessed resident performance in 6 learning sites within our residency. Data are represented on a radar graph, which residents and faculty used to recognize both strengths and areas for growth to guide educational planning for the individual learner.
Initial data show that the radar graphs have construct validity because the development process accurately reflects the desired construct, assessors were adequately trained, and the radar graphs demonstrated resident growth over time. A form completion rate of 90% for >1500 disseminated assessments suggests the feasibility of our process.
The radar graph is a promising tool for use in resident feedback and competency assessment. Further research is needed to determine the full utility of the radar graphs, including a better understanding of the tool's reliability and construct validity.
尽管近年来认证机构倾向于基于能力的评估,但对于如何最佳评估医学能力尚无共识。直接观察是一种有用的工具。与此同时,基于直接观察的综合评估系统一直难以开发。
我们开发了一个系统,该系统将从教育活动期间完成的观察行为清单中获得的数据(包括对临床护理的直接观察)转化为一种图形工具(“雷达图”),可用于形成性评估和总结性评估。我们使用独特的、可观察到的行为来评估德雷福斯量表上的能力水平,评估了我们住院医师培训项目中6个学习地点的住院医师表现。数据以雷达图的形式呈现,住院医师和教员可据此识别优势和成长领域,以指导针对个体学习者的教育规划。
初步数据表明,雷达图具有结构效度,因为其开发过程准确反映了预期结构,评估人员经过了充分培训,并且雷达图显示了住院医师随时间的成长。超过1500次分发评估的表格填写率为90%,表明我们的流程具有可行性。
雷达图是用于住院医师反馈和能力评估的一种很有前景的工具。需要进一步研究以确定雷达图的全部效用,包括更好地理解该工具的可靠性和结构效度。