From the Department of Ophthalmology (Pittner, Nolan, Bouchard), Loyola University Medical Center, the Department of Ophthalmology & Visual Sciences (Traish, Farooq), University of Illinois at Chicago, the Department of Ophthalmology (Feder), Northwestern University, the Division of Ophthalmology (Hill, Dwarakanathan), John H. Stroger Jr. Hospital of Cook County, and the Department of Medical Education (McGaghie), Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
From the Department of Ophthalmology (Pittner, Nolan, Bouchard), Loyola University Medical Center, the Department of Ophthalmology & Visual Sciences (Traish, Farooq), University of Illinois at Chicago, the Department of Ophthalmology (Feder), Northwestern University, the Division of Ophthalmology (Hill, Dwarakanathan), John H. Stroger Jr. Hospital of Cook County, and the Department of Medical Education (McGaghie), Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
J Cataract Refract Surg. 2016 Jun;42(6):855-63. doi: 10.1016/j.jcrs.2016.03.031.
To assess interrater reliability in grading cataract surgery performance of ophthalmology residents and attending physicians before and after rater skill training.
Metropolitan Chicago, Illinois, USA.
Prospective interventional test design.
Video versions of a previously validated scoring key for rating cataract surgery were created for participant training. All participants received 2 frame-of-reference training sessions lasting 2 hours each. Participants graded 4 videorecorded cataract surgeries before training (pretest) and 4 more after training (posttest). Intraclass correlation coefficients (ICCs), which measured the degree of rater agreement, were calculated before and after training. Participants completed a subjective confidence questionnaire at the beginning and at the end of the study.
The study participants included 9 postgraduate year (PGY)-3 residents, 8 PGY-4 residents, and 5 ophthalmology attending physicians from 4 medical centers in metropolitan Chicago. The rater training sessions had the greatest increase in ICCs among PGY-3 residents. The ICC improvement between the PGY-4 residents and attending physicians was uneven. After training, all residents felt more confident about their ability to rate and to perform cataract surgery.
Learning to effectively grade performance of cataract surgery by reviewing video clips has the potential to be an important part of ophthalmology residency education. The benefit of such a protocol was greatest in the early stages of residency education and might provide a guideline for quality assessment that accelerates surgical skill development.
None of the authors has a financial or proprietary interest in any material or method mentioned.
在对眼科住院医师和主治医生进行分级培训前后，评估白内障手术表现的评分者间可靠性。
美国伊利诺伊州芝加哥都会区。
前瞻性干预测试设计。
为参与者培训创建了一个先前经过验证的评分关键的视频版本，用于评定白内障手术。所有参与者都接受了为期 2 小时的 2 次参照培训课程。参与者在培训前（预测试）和培训后（后测试）分别对 4 个视频记录的白内障手术进行了评分。计算了培训前后的组内相关系数（ICC），以衡量评分者的一致性程度。参与者在研究开始和结束时完成了一份主观信心问卷。
研究参与者包括来自芝加哥都会区 4 家医疗中心的 9 名住院医师 3 年级（PGY-3）、8 名 PGY-4 住院医师和 5 名主治医生。PGY-3 住院医师的评分者培训课程的 ICC 增加最大。PGY-4 住院医师和主治医生之间的 ICC 改善情况参差不齐。培训后，所有住院医师对自己评分和进行白内障手术的能力都更有信心。
通过观看视频剪辑来学习有效评定白内障手术表现有可能成为眼科住院医师教育的重要组成部分。这种方案的益处在住院医师教育的早期阶段最大，并且可能为加速手术技能发展的质量评估提供指导方针。
