Artemiou Elpida, Hecker Kent G, Adams Cindy L, Coe Jason B
J Vet Med Educ. 2015 Winter;42(4):315-23. doi: 10.3138/jvme.0215-023R. Epub 2015 Aug 28.
There is increasing pressure in veterinary education to teach and assess communication skills, with the Objective Structured Clinical Examination (OSCE) being the most common assessment method. Previous research reveals that raters are a large source of variance in OSCEs. This study focused on examining the effect of raters' professional background as a source of variance when assessing students' communication skills. Twenty-three raters were categorized according to their professional background: clinical sciences (n=11), basic sciences (n=4), clinical communication (n=5), or hospital administrator/clinical skills technicians (n=3). Raters from each professional background were assigned to the same station and assessed the same students during two four-station OSCEs. Students were in year 2 of their pre-clinical program. Repeated-measures ANOVA results showed that OSCE scores awarded by the rater groups differed significantly: (F(matched_station_1) [2,91]=6.97, p=.002), (F(matched_station_2) [3,90]=13.95, p=.001), (F(matched_station_3) [3,90]=8.76, p=.001), and ((Fmatched_station_4) [2,91]=30.60, p=.001). A significant time effect between the two OSCEs was calculated for matched stations 1, 2, and 4, indicating improved student performances. Raters with a clinical communication skills background assigned scores that were significantly lower compared to the other rater groups. Analysis of written feedback provided by the clinical sciences raters showed that they were influenced by the students' clinical knowledge of the case and that they did not rely solely on the communication checklist items. This study shows that it is important to consider rater background both in recruitment and training programs for communication skills' assessment.
兽医教育领域对教授和评估沟通技能的压力日益增大,客观结构化临床考试(OSCE)是最常用的评估方法。先前的研究表明,评分者是OSCE中差异的一大来源。本研究聚焦于考察评分者的专业背景作为评估学生沟通技能时差异来源的影响。23名评分者根据其专业背景进行了分类:临床科学(n = 11)、基础科学(n = 4)、临床沟通(n = 5)或医院管理人员/临床技能技术员(n = 3)。来自每个专业背景的评分者被分配到同一站点,并在两场四站点的OSCE中评估相同的学生。学生处于临床前课程的第二年。重复测量方差分析结果显示,评分者组给出的OSCE分数存在显著差异:(F(匹配站点1)[2,91]=6.97,p = .002),(F(匹配站点2)[3,90]=13.95,p = .001),(F(匹配站点3)[3,90]=8.76,p = .001),以及((F匹配站点4)[2,91]=30.60,p = .001)。对于匹配的站点1、2和4,计算出两场OSCE之间存在显著的时间效应,表明学生表现有所提高。具有临床沟通技能背景的评分者给出的分数明显低于其他评分者组。对临床科学评分者提供的书面反馈进行分析表明,他们受到学生对病例的临床知识的影响,并且他们并非仅依赖于沟通清单项目。本研究表明,在沟通技能评估的招聘和培训项目中考虑评分者背景很重要。