循证医学精通量表：通过多维标度法进行机构验证。

Tractenberg Rochelle E, Gushta Matthew M, Weinfeld Jeffrey M

a Departments of Neurology, Rehabilitation Medicine, and Biostatistics, Bioinformatics and Biomathematics , Georgetown University Medical Center , Washington, DC , USA.

b Research and Psychometrics , Amplify , Washington, DC , USA.

Teach Learn Med. 2016;28(2):152-65. doi: 10.1080/10401334.2016.1146599.

UNLABELLED

CONSTRUCT: In this study we describe a multidimensional scaling (MDS) exercise to validate the curricular elements composing a new Mastery Rubric (MR) for a curriculum in evidence-based medicine (EBM). This MR-EBM comprises 10 elements of knowledge, skills, and abilities (KSAs) representing our institutional learning goals of career-spanning engagement with EBM. An MR also includes developmental trajectories for each KSA, beginning with medical school coursework, including residency training, and outlining the qualifications of individuals to teach and mentor in EBM. The development was not part of the validation effort, as our curriculum is focused at a single stage (undergraduate medical students).

BACKGROUND

An MR comprises the desired KSAs for an entire curriculum, together with descriptions of a learner's performance and/or capabilities as they develop from novice to proficiency of the curricular target(s). The MR construct is intended to support curriculum development or refinement by capturing the KSAs that support the articulation of concrete learning goals; it also promotes assessment that demonstrates development in the target KSAs and encourages reflection and self-directed learning throughout the learner's career. Two other MRs have been published, and this is the first one specific to teaching and learning in medicine; this is also the first one created specifically to evaluate an existing curriculum.

APPROACH

To validate the dispersion of the elements of the EBM curriculum, the nine clinical instructors in the EBM two-course curriculum completed an MDS exercise, rating the similarities of the 10 curricular elements. MDS is a mathematical approach to understanding relationships among concepts/objects when these relationships are difficult to quantify. Eliciting similarity ratings biased the responses toward the null hypothesis (that the elements are not different).

RESULTS

MDS results suggested that the MR represents 10 different, although related, facets of the construct "evidence-based medicine." The results support the makeup of the MR-EBM, and its use to revise our EBM curriculum so that it is more closely aligned with this MR.

CONCLUSIONS

An MR is a tool, and the MR-EBM that we describe can be useful to develop or evaluate a curriculum in EBM. The MR tool is particularly compatible with the objectives of training for EBM and practice and can be applied to create or evaluate a curriculum using any topical KSA framework. The MR-EBM we describe could be adopted or adapted to represent other institutional objectives for EBM training.

未标注

构建：在本研究中，我们描述了一项多维标度（MDS）练习，以验证构成循证医学（EBM）课程新掌握性评分标准（MR）的课程要素。该循证医学掌握性评分标准（MR-EBM）包括10个知识、技能和能力（KSA）要素，代表了我们机构在整个职业生涯中参与循证医学的学习目标。一个掌握性评分标准（MR）还包括每个KSA的发展轨迹，从医学院课程开始，包括住院医师培训，并概述个人在循证医学教学和指导方面的资质。由于我们的课程专注于本科医学生这一单一阶段，所以其发展并非验证工作的一部分。

背景

一个掌握性评分标准（MR）包括整个课程所需的知识、技能和能力（KSA），以及学习者从新手发展到精通课程目标时的表现和/或能力描述。掌握性评分标准（MR）的构建旨在通过捕捉支持明确具体学习目标的知识、技能和能力（KSA）来支持课程开发或完善；它还促进评估，以证明目标知识、技能和能力（KSA）的发展，并鼓励学习者在整个职业生涯中进行反思和自主学习。另外两个掌握性评分标准（MR）已经发表，这是第一个专门针对医学教学与学习的标准；这也是第一个专门为评估现有课程而创建的标准。

方法

为了验证循证医学课程要素的分散性，循证医学两门课程的九名临床教师完成了一项多维标度（MDS）练习，对10个课程要素的相似性进行评分。多维标度（MDS）是一种数学方法，用于在难以量化概念/对象之间关系时理解它们之间的关系。引出相似性评分会使回答偏向于零假设（即要素没有差异）。

结果

多维标度（MDS）结果表明，掌握性评分标准（MR）代表了“循证医学”这一构建的10个不同但相关的方面。结果支持了循证医学掌握性评分标准（MR-EBM）的构成，以及其用于修订我们的循证医学课程，使其与该掌握性评分标准（MR）更紧密对齐。

结论

掌握性评分标准（MR）是一种工具，我们所描述的循证医学掌握性评分标准（MR-EBM）可用于开发或评估循证医学课程。掌握性评分标准（MR）工具特别符合循证医学培训和实践的目标，可应用于使用任何主题性知识、技能和能力（KSA）框架创建或评估课程。我们所描述的循证医学掌握性评分标准（MR-EBM）可以被采用或改编，以代表循证医学培训的其他机构目标。