Cheung Warren J, Dudek Nancy, Wood Timothy J, Frank Jason R
J Grad Med Educ. 2016 Oct;8(4):601-604. doi: 10.4300/JGME-D-15-00505.1.
Concerns over the quality of work-based assessment (WBA) completion has resulted in faculty development and rater training initiatives. Daily encounter cards (DECs) are a common form of WBA used in ambulatory care and shift work settings. A tool is needed to evaluate initiatives aimed at improving the quality of completion of this widely used form of WBA.
The completed clinical evaluation report rating (CCERR) was designed to provide a measure of the quality of documented assessments on in-training evaluation reports. The purpose of this study was to provide validity evidence to support using the CCERR to assess the quality of DEC completion.
Six experts in resident assessment grouped 60 DECs into 3 quality categories (high, average, and poor) based on how informative each DEC was for reporting judgments of the resident's performance. Eight supervisors (blinded to the expert groupings) scored the 10 most representative DECs in each group using the CCERR. Mean scores were compared to determine if the CCERR could discriminate based on DEC quality.
Statistically significant differences in CCERR scores were observed between all quality groups ( < .001). A generalizability analysis demonstrated the majority of score variation was due to differences in DECs. The reliability with a single rater was 0.95.
The CCERR is a reliable and valid tool to evaluate DEC quality. It can serve as an outcome measure for studying interventions targeted at improving the quality of assessments documented on DECs.
对基于工作的评估(WBA)完成质量的担忧促使了教师发展和评分者培训计划的开展。日常会诊卡片(DEC)是门诊护理和轮班工作环境中常用的一种WBA形式。需要一种工具来评估旨在提高这种广泛使用的WBA形式完成质量的计划。
完成的临床评估报告评分(CCERR)旨在衡量培训期间评估报告中记录的评估质量。本研究的目的是提供效度证据,以支持使用CCERR来评估DEC完成的质量。
六位住院医师评估专家根据每份DEC对报告住院医师表现判断的信息量,将60份DEC分为3个质量类别(高、中、低)。八位主管(对专家分组不知情)使用CCERR对每组中最具代表性的10份DEC进行评分。比较平均得分,以确定CCERR是否能根据DEC质量进行区分。
在所有质量组之间观察到CCERR得分存在统计学显著差异(<0.001)。一项可推广性分析表明,大部分得分差异是由于DEC的差异所致。单个评分者的信度为0.95。
CCERR是评估DEC质量的可靠且有效的工具。它可以作为一种结果指标,用于研究旨在提高DEC上记录的评估质量的干预措施。