Schmutz Jan, Manser Tanja, Keil Julia, Heimberg Ellen, Hoffmann Florian
Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland.
Institute for Patient Safety, University Hospital Bonn, Bonn, Germany.
J Pediatr. 2015 Jun;166(6):1498-504.e1. doi: 10.1016/j.jpeds.2015.03.015. Epub 2015 Apr 15.
To develop and validate 3 performance evaluation checklists (PECs) for systematic performance assessment in 3 clinical scenarios: cardiopulmonary arrest, dyspnea with oxygen desaturation after intubation, and respiratory syncytial virus (RSV).
The 3 PECs were developed using an integrative approach and used to rate 50 training sessions in a simulator environment by different raters. Construct validity was tested by correlating the checklist scores with external constructs (ie, global rating, team experience level, and time to action). Further interrater reliability was tested for all 3 PECs.
The PECs for the desaturation and cardiopulmonary arrest scenarios were valid and reliable, whereas the PEC for RSV had limited validity and reliability.
For 2 pediatric emergencies, the PEC is a valid and reliable tool for systematic performance assessment. The unsatisfactory results for the PEC for RSV may be related to limitations of the simulation setting and require further investigation. Structured assessment of clinical performance can augment feedback on technical performance aspects and is essential for training purposes as well as for research. Only reliable and valid performance measures will allow medical educators to accurately evaluate the behavioral effects of training interventions and further enhance the quality of patient care.
制定并验证3份绩效评估清单(PEC),用于对3种临床场景进行系统的绩效评估,这3种临床场景分别为:心肺骤停、插管后伴有氧饱和度下降的呼吸困难以及呼吸道合胞病毒(RSV)感染。
采用综合方法制定这3份PEC,并由不同评分者在模拟环境中对50次培训课程进行评分。通过将清单得分与外部指标(即总体评分、团队经验水平和行动时间)进行关联来检验结构效度。对所有3份PEC进一步检验评分者间信度。
氧饱和度下降和心肺骤停场景的PEC有效且可靠,而RSV场景的PEC有效性和可靠性有限。
对于2种儿科急症,PEC是进行系统绩效评估的有效且可靠的工具。RSV场景下PEC的结果不尽人意可能与模拟环境的局限性有关,需要进一步研究。对临床绩效进行结构化评估可以增加对技术绩效方面的反馈,对培训目的以及研究而言都至关重要。只有可靠且有效的绩效指标才能让医学教育工作者准确评估培训干预措施的行为效果,并进一步提高患者护理质量。