McConnell Meghan, Sherbino Jonathan, Chan Teresa M
J Grad Med Educ. 2016 Dec;8(5):708-712. doi: 10.4300/JGME-D-16-00142.1.
The increasing use of workplace-based assessments (WBAs) in competency-based medical education has led to large data sets that assess resident performance longitudinally. With large data sets, problems that arise from missing data are increasingly likely.
The purpose of this study is to examine (1) whether data are missing at random across various WBAs, and (2) the relationship between resident performance and the proportion of missing data.
During 2012-2013, a total of 844 WBAs of CanMEDs Roles were completed for 9 second-year emergency medicine residents. To identify whether missing data were randomly distributed across various WBAs, the total number of missing data points was calculated for each Role. To examine whether the amount of missing data was related to resident performance, 5 faculty members rank-ordered the residents based on performance. A median rank score was calculated for each resident and was correlated with the proportion of missing data.
More data were missing for Health Advocate and Professional WBAs relative to other competencies ( < .001). Furthermore, resident rankings were not related to the proportion of missing data points ( = 0.29, > .05).
The results of the present study illustrate that some CanMEDS Roles are less likely to be assessed than others. At the same time, the amount of missing data did not correlate with resident performance, suggesting lower-performing residents are no more likely to have missing data than their higher-performing peers. This article discusses several approaches to dealing with missing data.
基于能力的医学教育中,基于工作场所的评估(WBA)使用越来越多,产生了大量纵向评估住院医师表现的数据集。随着数据集增大,缺失数据引发的问题越来越可能出现。
本研究旨在探讨(1)不同WBA中数据是否随机缺失,以及(2)住院医师表现与缺失数据比例之间的关系。
2012 - 2013年期间,9名二年级急诊医学住院医师共完成了844项加拿大医学教育认证委员会(CanMEDs)角色的WBA。为确定缺失数据是否在不同WBA中随机分布,计算了每个角色的缺失数据点总数。为检验缺失数据量是否与住院医师表现相关,5名教员根据表现对住院医师进行了排序。计算每个住院医师的中位排名分数,并将其与缺失数据比例进行相关性分析。
相对于其他能力,健康倡导者和专业WBA的缺失数据更多(<0.001)。此外,住院医师排名与缺失数据点比例无关(=0.29,>0.05)。
本研究结果表明,某些CanMEDs角色被评估的可能性低于其他角色。同时,缺失数据量与住院医师表现无关,这表明表现较差的住院医师与表现较好的同行相比,出现缺失数据的可能性并不更高。本文讨论了几种处理缺失数据的方法。