来自儿科实习生和实习医生对儿科里程碑子集评分的效度证据。

Validity Evidence From Ratings of Pediatric Interns and Subinterns on a Subset of Pediatric Milestones.

作者信息

Turner Teri L, Bhavaraju Vasudha L, Luciw-Dubas Ulana A, Hicks Patricia J, Multerer Sara, Osta Amanda, McDonnell Jennifer, Poynter Sue, Schumacher Daniel J, Tenney-Soeiro Rebecca, Waggoner-Fountain Linda, Schwartz Alan

机构信息

T.L. Turner is associate professor, Department of Pediatrics, Baylor College of Medicine, and director, Center for Research, Innovation, and Scholarship in Medical Education, Texas Children's Hospital, Houston, Texas. V.L. Bhavaraju is program director, Phoenix Children's Hospital/Maricopa Medical Center Pediatric Residency Program, Phoenix, Arizona, and clinical assistant professor, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona. U.A. Luciw-Dubas is research measurement analyst, Measurement Consulting Services, National Board of Medical Examiners, Philadelphia, Pennsylvania. P.J. Hicks is professor of clinical pediatrics, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, and director, Pediatrics Milestones Assessment Collaborative, Philadelphia, Pennsylvania. S. Multerer is associate professor, Department of Pediatrics, University of Louisville School of Medicine and Kosair Children's Hospital, Louisville, Kentucky. A. Osta is assistant professor of clinical pediatrics and internal medicine, and pediatrics program director, Department of Pediatrics, University of Illinois-Chicago and Children's Hospital University of Illinois, Chicago, Illinois. J. McDonnell was assistant professor of medicine, University of Illinois at Chicago, Chicago, Illinois, at the time this was written. She is now assistant professor of pediatrics, Department of Pediatrics, Rush University, Chicago, Illinois. S. Poynter is associate professor of pediatrics, Department of Pediatrics, University of Cincinnati, and codirector, pediatric residency training program, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. D.J. Schumacher is assistant professor of pediatrics, Department of Pediatrics, University of Cincinnati/Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. R. Tenney-Soeiro is associate professor of clinical pediatrics, Department of Pediatrics, and codirector, pediatric clerkship, Perelman School of Medicine, University of Pennsylvania and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. L. Waggoner-Fountain is program director and associate professor of pediatrics, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia. A. Schwartz is Michael Reese Endowed Professor and associate head of medical education and research professor of pediatrics, University of Illinois at Chicago, Chicago, Illinois, and director, Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN), McLean, Virginia.

出版信息

Acad Med. 2017 Jun;92(6):809-819. doi: 10.1097/ACM.0000000000001622.

DOI:10.1097/ACM.0000000000001622

PMID:28557947

Abstract

PURPOSE

To investigate evidence for validity of faculty members' pediatric milestone (PM) ratings of interns (first-year residents) and subinterns (fourth-year medical students) on nine subcompetencies related to readiness to serve as a pediatric intern in the inpatient setting.

METHOD

The Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN) and the National Board of Medical Examiners collaborated to investigate the utility of assessments of the PMs for trainees' performance. Data from 32 subinterns and 179 interns at 17 programs were collected from July 2012 through April 2013. Observers used several tools to assess learners. At each site, a faculty member used these data to make judgments about the learner's current developmental milestone in each subcompetency. Linear mixed models were fitted to milestone judgments to examine their relationship with learner's rank and subcompetency.

RESULTS

On a 5-point developmental scale, mean milestone levels for interns ranged from 3.20 (for the subcompetency Work effectively as a member of a team) to 3.72 (Humanism) and for subinterns from 2.89 (Organize and prioritize care) to 3.61 (Professionalization). Mean milestone ratings were significantly higher for the Professionalism competency (3.59-3.72) for all trainees compared with Patient Care (2.89-3.24) and Personal and Professional Development (3.33-3.51). Mean intern ratings were significantly higher than mean subintern ratings for all nine subcompetencies except Professionalization, Humanism, and Trustworthiness.

CONCLUSIONS

The PMs had a coherent internal structure and could distinguish between differing levels of trainees, which supports their validation for documenting developmental progression of pediatric trainees.

摘要

目的

调查教员对实习医生（一年级住院医师）和准实习医生（四年级医学生）在与住院环境中担任儿科实习医生的准备情况相关的九项亚能力方面的儿科里程碑（PM）评分的有效性证据。

方法

儿科项目主任协会纵向教育评估研究网络（APPD LEARN）和美国国家医学考试委员会合作，调查PM评估对学员表现的效用。2012年7月至2013年4月收集了17个项目中32名准实习医生和179名实习医生的数据。观察者使用多种工具评估学习者。在每个地点，一名教员利用这些数据对学习者在每项亚能力方面当前的发展里程碑做出判断。对里程碑判断拟合线性混合模型，以检验它们与学习者排名和亚能力的关系。

结果

在5分制的发展量表上，实习医生的平均里程碑水平从3.20（团队合作亚能力）到3.72（人文精神）不等，准实习医生的平均里程碑水平从2.89（组织护理并确定优先顺序）到3.61（职业化）不等。与患者护理（2.89 - 3.24）和个人与职业发展（3.33 - 3.51）相比，所有学员的职业化能力平均里程碑评分（3.59 - 3.72）显著更高。除职业化、人文精神和可信赖性外，所有九项亚能力的实习医生平均评分均显著高于准实习医生平均评分。