Winkel Abigail Ford, Gillespie Colleen, Uquillas Kristen, Zabar Sondra, Szyld Demian
Department of Obstetrics & Gynecology, New York University School of Medicine.
Institute for Innovations in Medical Education, Department of Medicine, New York University School of Medicine, NYU-HHC Clinical and Translational Sciences Institute, New York, New York.
J Surg Educ. 2016 Mar-Apr;73(2):230-7. doi: 10.1016/j.jsurg.2015.10.004.
The Test of Integrated Professional Skills (TIPS) is an objective structured clinical examination-simulation hybrid examination that assesses resident integration of technical, cognitive, and affective skills in Obstetrics and Gynecology (OBGYN) residents. The aim of this study was to analyze performance patterns and reactions of residents to the test to understand how it may fit within a comprehensive assessment program.
A retrospective, mixed methods review of the design and implementation of the examination, patterns of performance of trainees at different levels of training, focus group data, and description of use of TIPS results for resident remediation and curriculum development.
OBGYN residents at New York University Langone Medical Center, a tertiary-care, urban academic health center.
OBGYN residents in all years of training, postgraduate year-1 through postgraduate year, all residents completing the TIPS examination and consenting to participate in focus groups were included.
In all, 24 residents completed the TIPS examination. Performance on the examination varied widely among individuals at each stage of training, and did not follow developmental trends, except for technical skills. Cronbach α for both standardized patient and faculty ratings ranged from 0.69 to 0.84, suggesting internal consistency. Focus group results indicated that residents respond to the TIPS examination in complex ways, ranging from anxiety about performance to mixed feelings about how to use the data for their learning.
TIPS assesses a range of attributes, and can support both formative and summative evaluation. Lack of clear developmental differences and wide variation in performance by learners at the same level of training support the argument for individualized learning plans and competency-based education.
综合专业技能测试（TIPS）是一种客观结构化临床考试 - 模拟混合考试，用于评估妇产科住院医师技术、认知和情感技能的综合运用能力。本研究的目的是分析住院医师在该测试中的表现模式及反应，以了解其如何适用于综合评估项目。
对考试的设计与实施、不同培训水平学员的表现模式、焦点小组数据以及TIPS结果在住院医师补习和课程开发中的应用描述进行回顾性混合方法研究。
纽约大学朗格尼医学中心，一家三级城市学术医疗中心的妇产科住院医师培训项目。
纳入所有培训年份的妇产科住院医师，即从研究生一年级到研究生阶段，所有完成TIPS考试并同意参加焦点小组的住院医师。
共有24名住院医师完成了TIPS考试。在每个培训阶段，个体在考试中的表现差异很大，除技术技能外，未呈现发展趋势。标准化患者和教员评分的Cronbach α系数在0.69至0.84之间，表明具有内部一致性。焦点小组结果表明，住院医师对TIPS考试的反应复杂，从对表现的焦虑到对如何利用数据进行学习的复杂感受。
TIPS评估一系列属性，可支持形成性和总结性评估。在相同培训水平的学习者中缺乏明显的发展差异以及表现差异较大支持了个性化学习计划和基于能力的教育的观点。
