研究生教育环境领域扫描工具（SPEED）的开发与验证：一种评估研究生医学教育环境的简短工具
Development and Validation of the Scan of Postgraduate Educational Environment Domains (SPEED): A Brief Instrument to Assess the Educational Environment in Postgraduate Medical Education.
作者信息
Schönrock-Adema Johanna, Visscher Maartje, Raat A N Janet, Brand Paul L P
机构信息
Center for Educational Development and Research in health sciences, Institute for Medical Education, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
UMCG Postgraduate School of Medicine, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
出版信息
PLoS One. 2015 Sep 28;10(9):e0137872. doi: 10.1371/journal.pone.0137872. eCollection 2015.
INTRODUCTION
Current instruments to evaluate the postgraduate medical educational environment lack theoretical frameworks and are relatively long, which may reduce response rates. We aimed to develop and validate a brief instrument that, based on a solid theoretical framework for educational environments, solicits resident feedback to screen the postgraduate medical educational environment quality.
METHODS
Stepwise, we developed a screening instrument, using existing instruments to assess educational environment quality and adopting a theoretical framework that defines three educational environment domains: content, atmosphere and organization. First, items from relevant existing instruments were collected and, after deleting duplicates and items not specifically addressing educational environment, grouped into the three domains. In a Delphi procedure, the item list was reduced to a set of items considered most important and comprehensively covering the three domains. These items were triangulated against the results of semi-structured interviews with 26 residents from three teaching hospitals to achieve face validity. This draft version of the Scan of Postgraduate Educational Environment Domains (SPEED) was administered to residents in a general and university hospital and further reduced and validated based on the data collected.
RESULTS
Two hundred twenty-three residents completed the 43-item draft SPEED. We used half of the dataset for item reduction, and the other half for validating the resulting SPEED (15 items, 5 per domain). Internal consistencies were high. Correlations between domain scores in the draft and brief versions of SPEED were high (>0.85) and highly significant (p<0.001). Domain score variance of the draft instrument was explained for ≥80% by the items representing the domains in the final SPEED.
CONCLUSIONS
The SPEED comprehensively covers the three educational environment domains defined in the theoretical framework. Because of its validity and brevity, the SPEED is promising as useful and easily applicable tool to regularly screen educational environment quality in postgraduate medical education.
引言
当前用于评估研究生医学教育环境的工具缺乏理论框架且相对冗长，这可能会降低回复率。我们旨在开发并验证一种简短的工具，该工具基于坚实的教育环境理论框架，征求住院医师的反馈意见，以筛查研究生医学教育环境质量。
方法
我们逐步开发了一种筛查工具，利用现有的工具来评估教育环境质量，并采用一个定义了三个教育环境领域的理论框架：内容、氛围和组织。首先，收集相关现有工具中的条目，在删除重复项和未专门涉及教育环境的条目后，将其分为三个领域。在德尔菲法过程中，条目列表被缩减为一组被认为最重要且全面涵盖这三个领域的条目。将这些条目与来自三家教学医院的26名住院医师的半结构化访谈结果进行三角验证，以实现表面效度。将这份研究生教育环境领域扫描（SPEED）初稿分发给一家综合医院和一家大学医院的住院医师，并根据收集到的数据进一步缩减和验证。
结果
223名住院医师完成了包含43个条目的SPEED初稿。我们将一半的数据集用于条目缩减，另一半用于验证最终的SPEED（15个条目，每个领域5个）。内部一致性较高。SPEED初稿和简短版本中各领域得分之间的相关性较高（>0.85）且高度显著（p<0.001）。最终SPEED中代表各领域的条目解释了初稿工具中各领域得分方差的≥80%。
结论
SPEED全面涵盖了理论框架中定义的三个教育环境领域。由于其有效性和简洁性，SPEED有望成为一种有用且易于应用的工具，用于定期筛查研究生医学教育中的教育环境质量。
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