Sowden Gillian L, Vestal Heather S, Stoklosa Joseph B, Valcourt Stephanie C, Peabody John W, Keary Christopher J, Nejad Shamim H, Caminis Argyro, Huffman Jeff C
Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
McLean Hospital, Belmont, MA, USA.
Acad Psychiatry. 2017 Jun;41(3):364-368. doi: 10.1007/s40596-016-0604-1. Epub 2016 Aug 16.
While standardized patients (SPs) remain the gold standard for assessing clinical competence in a standardized setting, clinical case vignettes that allow free-text, open-ended written responses are more resource- and time-efficient assessment tools. It remains unknown, however, whether this is a valid method for assessing competence in the management of agitation.
Twenty-six psychiatry residents partook in a randomized controlled study evaluating a simulation-based teaching intervention on the management of agitated patients. Competence in the management of agitation was assessed using three separate modalities: simulation with SPs, open-ended clinical vignettes, and self-report questionnaires.
Performance on clinical vignettes correlated significantly with SP-based assessments (r = 0.59, p = 0.002); self-report questionnaires that assessed one's own ability to manage agitation did not correlate with SP-based assessments (r = -0.06, p = 0.77).
Standardized clinical vignettes may be a simple, time-efficient, and valid tool for assessing residents' competence in the management of agitation.
虽然标准化患者仍然是在标准化环境中评估临床能力的金标准，但允许自由文本、开放式书面回答的临床病例 vignettes 是更具资源和时间效率的评估工具。然而，这是否是评估激越管理能力的有效方法仍不清楚。
26 名精神科住院医师参与了一项随机对照研究，评估基于模拟的针对激越患者管理的教学干预。使用三种不同方式评估激越管理能力：与标准化患者进行模拟、开放式临床 vignettes 和自我报告问卷。
临床 vignettes 的表现与基于标准化患者的评估显著相关（r = 0.59，p = 0.002）；评估自身激越管理能力的自我报告问卷与基于标准化患者的评估不相关（r = -0.06，p = 0.77）。
标准化临床 vignettes 可能是评估住院医师激越管理能力的一种简单、省时且有效的工具。
