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风湿病客观结构化临床检查评估清单专家小组共识

Expert panel consensus on assessment checklists for a rheumatology objective structured clinical examination.

作者信息

Criscione-Schreiber Lisa G, Sloane Richard J, Hawley Jeffrey, Jonas Beth L, O'Rourke Kenneth S, Bolster Marcy B

机构信息

Duke University, Durham, North Carolina.

University of North Carolina, Chapel Hill.

出版信息

Arthritis Care Res (Hoboken). 2015 Jul;67(7):898-904. doi: 10.1002/acr.22543.

Abstract

OBJECTIVE

While several regional fellowship groups conduct rheumatology objective structured clinical examinations (ROSCEs), none have been validated for use across programs. We aimed to establish agreement among subspecialty experts regarding checklist items for several ROSCE stations.

METHODS

We administered a 1-round survey to assess the importance of 173 assessment checklist items for 11 possible ROSCE stations. We e-mailed the survey to 127 rheumatology educators from across the US. Participants rated each item's importance on a 5-point Likert scale (1 = not important to 5 = very important). Consensus for high importance was predefined as a lower bound of the 95% confidence interval ≥4.0.

RESULTS

Twenty-five individuals (20%) completed the expert panel survey. A total of 133 of the 173 items (77%) met statistical cutoff for consensus to retain. Several items that had population means of ≥4.0 but did not meet the predetermined definition for consensus were rejected. The percentage of retained items for individual stations ranged from 24% to 100%; all items were retained for core elements of patient counseling and radiograph interpretation tasks. Only 24% of items were retained for a rehabilitation medicine station and 60% for a microscope use/synovial fluid analysis station.

CONCLUSION

This single-round expert panel survey established consensus on 133 items to assess on 11 proposed ROSCE stations. The method used in this study, which can engage a diverse geographic representation and employs rigorous statistical methods to establish checklist content agreement, can be used in any medical field.

摘要

目的

虽然有几个地区性的 fellowship 小组开展了风湿病客观结构化临床考试(ROSCEs),但尚无一个经过验证可在各项目中通用。我们旨在就多个 ROSCE 站点的检查清单项目在亚专科专家之间达成共识。

方法

我们进行了一轮调查,以评估 173 个评估检查清单项目对于 11 个可能的 ROSCE 站点的重要性。我们通过电子邮件将调查问卷发送给来自美国各地的 127 名风湿病教育工作者。参与者根据 5 点李克特量表(1 = 不重要至 5 = 非常重要)对每个项目的重要性进行评分。预先将高度重要性的共识定义为 95%置信区间的下限≥4.0。

结果

25 人(20%)完成了专家小组调查。173 个项目中的 133 个(77%)达到了保留共识的统计临界值。一些总体均值≥4.0 但未达到预定共识定义的项目被否决。各个站点保留项目的百分比从 24%到 100%不等;患者咨询和 X 光片解读任务的核心要素的所有项目均被保留。康复医学站点仅 24%的项目被保留,显微镜使用/滑液分析站点为 60%。

结论

这项单轮专家小组调查就 11 个拟议的 ROSCE 站点的 133 个评估项目达成了共识。本研究中使用的方法能够涵盖不同的地域代表,并采用严格的统计方法来确定检查清单内容的一致性,可应用于任何医学领域。

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