Oktay Cem, Senol Yesim, Rinnert Stephan, Cete Yildiray
Akdeniz University School of Medicine, Department of Emergency Medicine, Antalya, Turkey.
Akdeniz University School of Medicine, Department of Medical Education, Antalya, Turkey.
Turk J Emerg Med. 2016 Nov 27;17(1):12-15. doi: 10.1016/j.tjem.2016.09.007. eCollection 2017 Mar.
This study was designed to test a 360-degree assessment tool for four of the emergency medicine resident competencies as outlined by the Council of Residency Directors in Emergency Medicine on patient care, communication skills, professionalism and system based practice in an academic Emergency Department.
Using the competency framework of the American Accreditation Council for Graduate Medical Education, a 57 item-containing assessment tool was created. Based on the different exposure aspects of the involved evaluator groups, the items were integrated into seven different evaluation forms. All sixteen of 16 residents and members from each evaluator group voluntarily participated in the study. Internal consistency scores, multilayer and multilevel Kappa values were measured. Evaluator group scores and resident ranks in competency areas were compared. All evaluators were asked to comment on the applicability and usefulness of the assessment tool in emergency medicine.
Seven groups completed a total of 1088 forms to evaluate 16 residents. The reliability coefficient for the faculty members was 0.99 while it was 0.60 for the ancillary staff. The interrater Kappa values for faculty members, nurses and peer assessment were relevant with a value of greater than 70%.
Our results showed that the 360-degree assessment did meet expectations by the evaluator group and residents, and that this method was readily accepted in the setting of a Akdeniz University Emergency Medicine residency training program. However, only evaluations by faculty, nurses, self and peers were reliable to have any value. Doing a 360° evaluation is time and effort consuming and thus may not be an ideal tool for larger programs.
本研究旨在测试一种360度评估工具,用于评估急诊医学住院医师主任委员会所概述的四项急诊医学住院医师能力,即患者护理、沟通技巧、职业素养和基于系统的实践,研究在一所学术性急诊科进行。
利用美国毕业后医学教育认证委员会的能力框架,创建了一个包含57个条目的评估工具。根据参与评估的不同评估者群体的不同接触方面,这些条目被整合到七种不同的评估表格中。16名住院医师和每个评估者群体的成员全部自愿参与了该研究。测量了内部一致性得分、多层和多级卡帕值。比较了评估者群体得分和住院医师在各能力领域的排名。所有评估者都被要求对该评估工具在急诊医学中的适用性和实用性发表评论。
七个评估者群体共完成了1088份表格,用于评估16名住院医师。教员的可靠性系数为0.99,而辅助人员的可靠性系数为0.60。教员、护士和同行评估的评估者间卡帕值相关,均大于70%。
我们的结果表明,360度评估确实达到了评估者群体和住院医师的期望,并且这种方法在阿克德尼兹大学急诊医学住院医师培训项目中很容易被接受。然而,只有教员、护士、自我和同行的评估可靠且有价值。进行360度评估既耗时又费力,因此可能不是大型项目的理想工具。