Wroe Emily B, McBain Ryan K, Michaelis Annie, Dunbar Elizabeth L, Hirschhorn Lisa R, Cancedda Corrado
J Grad Med Educ. 2017 Aug;9(4):467-472. doi: 10.4300/JGME-D-16-00848.1.
Despite rapid growth in the number of physicians and academic institutions entering the field of global health, there are few tools that inform global health curricula and assess physician readiness for this field.
To address this gap, we describe the development and pilot testing of a new tool to assess nontechnical competencies and values in global health. Competencies assessed include systems-based practice, interpersonal and cross-cultural communication, professionalism and self-care, patient care, mentoring, teaching, management, and personal motivation and experience.
The Global Health Delivery Competency Assessment Tool presents 15 case vignettes and open-ended questions related to situations a global health practitioner might encounter, and grades the quality of responses on a 6-point ordinal scale. We interviewed 17 of 18 possible global health residents (94%), matched with 17 residents not training in global health, for a total of 34 interviews. A second reviewer independently scored recordings of 13 interviews for reliability.
Pilot testing indicated a high degree of discriminant validity, as measured by the instrument's ability to distinguish between residents who were and were not enrolled in a global health program ( < .001). It also demonstrated acceptable consistency, as assessed by interrater reliability (κ = 0.53), with a range of item-level agreement from 84%-96%.
The tool has potential applicability to a variety of academic and programmatic activities, including evaluation of candidates for global health positions and evaluating the success of training programs in equipping practitioners for entry into this field.
尽管进入全球健康领域的医生和学术机构数量迅速增长,但用于指导全球健康课程设置并评估医生是否为此领域做好准备的工具却很少。
为填补这一空白,我们描述了一种用于评估全球健康领域非技术能力和价值观的新工具的开发及试点测试情况。所评估的能力包括基于系统的实践、人际及跨文化交流、职业素养与自我保健、患者护理、指导、教学、管理以及个人动机和经验。
全球健康服务能力评估工具呈现了15个病例 vignettes 以及与全球健康从业者可能遇到的情况相关的开放式问题,并以6分序数尺度对回答质量进行评分。我们对18名可能的全球健康住院医师中的17名(94%)进行了访谈,同时匹配了17名未接受全球健康培训的住院医师,共进行了34次访谈。另一位评审员独立对13次访谈的记录进行评分以评估信度。
试点测试表明该工具具有高度的区分效度,这通过其区分参加和未参加全球健康项目的住院医师的能力来衡量(<0.001)。通过评分者间信度评估(κ = 0.53),其一致性也可接受,项目层面的一致性范围为84% - 96%。
该工具在各种学术和项目活动中具有潜在的适用性,包括评估全球健康职位的候选人以及评估培训项目在使从业者为进入该领域做好准备方面的成效。