Riveros Ricardo, Kimatian Stephen, Castro Pilar, Dhumak Vipul, Honar Hooman, Mascha Edward J, Sessler Daniel I
Department of Pediatric Anesthesia and Outcomes Research, Cleveland Clinic.
Department of Pediatric Anesthesia, Cleveland Clinic.
J Clin Anesth. 2016 Nov;34:32-40. doi: 10.1016/j.jclinane.2016.03.038. Epub 2016 Apr 29.
To assess professionalism in anesthesiology residents, it is important to obtain evaluations from people with whom they interact on daily basis. The purpose of this study was to evaluate the effect of a Multisource feedback (MSF) on resident's professional behavior and to assess the effect of faculty feedback on resident performance.
This study was a two-group randomized clinical trial.
Residents were recruited from Cleveland Clinic Children's Hospital.
Participants included twenty eight residents doing a two-month rotation in Pediatric Anesthesia.
Multisource feedback questionnaires were developed and then validated using face and content validity. Residents were randomly assigned to a feedback group or a control group. Both groups received the MSF evaluation. Only the group assigned to feedback had a 'coaching meeting' every month creating strategies for improvement.
MSF questionnaires were validated using a face validation and expert content validity. The effect of MSF on a professionalism questionnaire was assessed using analysis of covariance and linear mixed effects regression models.
Observed test-retest agreement was greater than 0.90 for all items, with more than half of kappa statistics greater than 0.50. Cronbach's alpha was 0.71.The MSF increased the self-assessment score with an estimated effect of 0.21 (95% CI 0.06, 0.37), P=.015. There was no detected effect on patient family evaluation, with mean difference (CI) in change from baseline of 0.03 (-0.15, 0.21), P=.77, faculty evaluation, 0.21 (-0.02, 0.44), P=.08, or coworker evaluation 0.13 (-0.11, 0.37).
Our new multi-source feedback questionnaire to assess professionalism had good reliability and internal consistency. Using our validated questionnaire we assessed the effect of a monthly feedback to improve professionalism in anesthesia residents. While we did see improvement in anesthesiology residents' self-assessment, we did not see a similar effect on patient family, faculty or coworker evaluations.
为评估麻醉科住院医师的职业素养，获取与他们日常互动人员的评价很重要。本研究的目的是评估多源反馈（MSF）对住院医师职业行为的影响，并评估教员反馈对住院医师表现的影响。
本研究为两组随机临床试验。
住院医师来自克利夫兰诊所儿童医院。
参与者包括28名正在进行为期两个月小儿麻醉轮转的住院医师。
开发多源反馈问卷，然后通过表面效度和内容效度进行验证。住院医师被随机分配到反馈组或对照组。两组都接受多源反馈评估。只有被分配到反馈组的人员每月召开一次“指导会议”以制定改进策略。
多源反馈问卷通过表面效度验证和专家内容效度验证。使用协方差分析和线性混合效应回归模型评估多源反馈对职业素养问卷的影响。
所有项目的重测一致性观察值均大于0.90，超过半数的kappa统计量大于0.50。克朗巴哈系数为0.71。多源反馈使自我评估得分提高，估计效应为0.21（95%置信区间0.06，0.37），P = 0.015。未检测到对患者家属评价的影响，从基线变化的平均差异（置信区间）为0.03（-0.15，0.21），P = 0.77，对教员评价的影响为0.21（-0.02，0.44），P = 0.08，对同事评价的影响为0.13（-0.11，0.37）。
我们新的用于评估职业素养的多源反馈问卷具有良好的信度和内部一致性。使用我们验证过的问卷，我们评估了每月反馈对提高麻醉科住院医师职业素养的影响。虽然我们确实看到麻醉科住院医师的自我评估有所改善，但在患者家属、教员或同事评价方面未看到类似效果。
