University of Campinas, Campinas, SP, Brazil.
Int J Med Inform. 2013 Sep;82(9):875-81. doi: 10.1016/j.ijmedinf.2013.04.010. Epub 2013 Jun 6.
To describe a model for assessing nursing diagnostic accuracy and its application to undergraduate students, comparing students' performance according to the course year.
This model, based on the theory of fuzzy sets, guides a student through three steps: (a) the student must parameterize the model by establishing relationship values between defining characteristic/risk factors and nursing diagnoses; (b) presentation of a clinical case; (c) the student must define the presence of each defining characteristic/risk factors for the clinical case. Subsequently, the model computes the most plausible diagnoses by taking into account the values indicated by the student. This gives the student a performance score in comparison with parameters and diagnoses that were previously provided by nursing experts. These nursing experts collaborated with the construction of the model indicating the strength of the relationship between the concepts, meaning, they parameterized the model to compare the student's choice with the expert's choice (gold standard), thus generating performance scores for the student. The model was tested using three clinical cases presented to 38 students in their third and fourth years of the undergraduate nursing course.
Third year students showed superior performance in identifying the presence of defining characteristic/risk factors, while fourth year students showed superior performance in the diagnoses by the model.
The Model for Evaluation of Diagnostic Accuracy Based on Fuzzy Logic applied in this study is feasible and can be used to evaluate students' performance. In this regard, it will open a broad variety of applications for learning and nursing research.
Despite the ease in filling the printed questionnaires out, the number of steps and fields to fill in may explain the considerable number of questionnaires with incorrect or missing data. This was solved in the digital version of the questionnaire. In addition, in more complex cases, it is possible that an expert opinion can lead to a wrong decision due to the subjectivity of the diagnostic process.
描述一种评估护理诊断准确性的模型及其在本科生中的应用,并根据课程年级比较学生的表现。
该模型基于模糊集理论,指导学生完成三个步骤:(a)学生必须通过建立定义特征/危险因素与护理诊断之间的关系值来参数化模型;(b)呈现临床病例;(c)学生必须为临床病例定义每个定义特征/危险因素的存在。随后,模型考虑学生指示的值来计算最可能的诊断。这为学生提供了与之前由护理专家提供的参数和诊断进行比较的绩效得分。这些护理专家参与了模型的构建,指示概念之间的关系强度,即他们参数化模型以比较学生的选择与专家的选择(金标准),从而为学生生成绩效得分。该模型使用三个临床病例对 38 名三年级和四年级护理专业学生进行了测试。
三年级学生在识别定义特征/危险因素的存在方面表现更好,而四年级学生在模型诊断方面表现更好。
本研究应用的基于模糊逻辑的诊断准确性评估模型是可行的,可以用于评估学生的表现。在这方面,它将为学习和护理研究开辟广泛的应用。
尽管打印问卷填写起来很方便,但填写的步骤和字段较多可能解释了相当数量的问卷存在不正确或缺失数据的情况。在问卷的数字版本中解决了这个问题。此外,在更复杂的情况下,由于诊断过程的主观性,专家意见可能导致错误的决策。