Obstetrics, Gynaecology and Women's Health Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
Med Educ. 2013 Jul;47(7):650-73. doi: 10.1111/medu.12220.
The Accreditation Council for Graduate Medical Education (ACGME) Milestone Project mandates programmes to assess the attainment of training outcomes, including the psychomotor (surgical or procedural) skills of medical trainees. The objectives of this study were to determine which tools exist to directly assess psychomotor skills in medical trainees on live patients and to identify the data indicating their psychometric and edumetric properties.
An electronic search was conducted for papers published from January 1948 to May 2011 using the PubMed, Education Resource Information Center (ERIC), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Web of Science electronic databases and the review of references in article bibliographies. A study was included if it described a tool or instrument designed for the direct observation of psychomotor skills in patient care settings by supervisors. Studies were excluded if they referred to tools that assessed only clinical or non-technical skills, involved non-medical health professionals, or assessed skills performed on a simulator. Overall, 4114 citations were screened, 168 (4.1%) articles were reviewed for eligibility and 51 (1.2%) manuscripts were identified as meeting the study inclusion criteria. Three authors abstracted and reviewed studies using a standardised form for the presence of key psychometric and edumetric elements as per ACGME and American Psychological Association (APA) recommendations, and also assigned an overall grade based on the ACGME Committee on Educational Outcome Assessment grading system.
A total of 30 tools were identified. Construct validity based on associations between scores and training level was identified in 24 tools, internal consistency in 14, test-retest reliability in five and inter-rater reliability in 20. The modification of attitudes, knowledge or skills was reported using five tools. The seven-item Global Rating Scale and the Procedure-Based Assessment received an overall Class 1 ACGME grade and are recommended based on Level A ACGME evidence.
Numerous tools are available for the assessment of psychomotor skills in medical trainees, but evidence supporting their psychometric and edumetric properties is limited.
研究生医学教育认证委员会（ACGME）里程碑项目要求计划评估培训成果的实现情况，包括医学生的心理运动（手术或程序）技能。本研究的目的是确定目前有哪些工具可直接评估在真实患者身上进行操作的医学生的心理运动技能，并确定表明其心理计量学和教育计量学特性的数据。
使用 PubMed、教育资源信息中心（ERIC）、护理与联合健康文献累积索引（CINAHL）和 Web of Science 电子数据库，对 1948 年 1 月至 2011 年 5 月期间发表的论文进行电子检索，并查阅文章参考文献。如果研究描述了一种工具或仪器，用于在患者护理环境中由主管人员直接观察心理运动技能，则将该研究纳入。如果研究仅涉及评估临床或非技术技能、涉及非医疗保健专业人员或评估在模拟器上进行的技能的工具，则将其排除在外。共筛选了 4114 条引文，有 168 篇（4.1%）文章符合资格标准，并进一步对其进行了评估，有 51 篇（1.2%）文章被确定符合研究纳入标准。三位作者使用标准化表格，根据 ACGME 和美国心理学会（APA）的建议，对存在的关键心理计量学和教育计量学要素进行摘要和审查，并根据 ACGME 教育成果评估委员会的分级系统，对总体等级进行分配。
共确定了 30 种工具。24 种工具的得分与培训水平之间存在结构效度，14 种工具具有内部一致性，5 种工具具有重测信度，20 种工具具有评分者间信度。有 5 种工具报告了对态度、知识或技能的改变。7 项整体评分量表和基于程序的评估获得了 ACGME 等级 1 的总体等级，根据 ACGME A 级证据推荐使用。
有许多工具可用于评估医学生的心理运动技能，但支持其心理计量学和教育计量学特性的证据有限。
