Centre for Medical Professional Development, John Hunter Hospital, Newcastle, NSW
Maastricht University, Maastricht, The Netherlands.
Med J Aust. 2017 Nov 20;207(10):453. doi: 10.5694/mja17.00130.
The fitness to practise of international medical graduates (IMGs) is usually evaluated with standardised assessment tests. The performance rather than the competency of practising doctors should, however, be assessed, for which reason workplace-based assessment (WBA) has gained increasing attention. Our aim was to assess the composite reliability of WBA instruments for assessing IMGs.
Between June 2010 and April 2015, 142 IMGs were assessed by 99 calibrated assessors; each was assessed in the workplace over 6 months. The IMGs completed 970 case-based discussions (CBDs), 1741 mini-clinical examination exercises (mini-CEX), and 1020 multi-source feedback (MSF) assessments.
103 male and 39 female candidates from 28 countries (Africa, Asia, Europe, South America, South Pacific) in urban and rural hospitals of the Hunter New England Health region.
The composite reliability across the three WBA tools, expressed as the standard error of measurement (SEM).
In our WBA program, a combination of five CBD and 12 mini-CEX assessments achieved an SEM of 0.33, greater than the threshold 0.26 of a scale point. Adding six MSF results to the assessment package reduced the SEM to 0.24, which is adequately precise.
Combining data from different WBA assessment instruments achieves acceptable reliability for assessing IMGs, provided that the panel of WBA assessment types are carefully selected and the assessors are calibrated.
国际医学毕业生（IMGs）的行医资格通常通过标准化评估测试进行评估。然而，应该评估的是执业医生的表现而不是能力，因此基于工作场所的评估（WBA）越来越受到关注。我们的目的是评估评估 IMG 的 WBA 工具的综合可靠性。
2010 年 6 月至 2015 年 4 月期间，142 名 IMG 由 99 名经过校准的评估员进行评估；每位评估员在工作场所接受了 6 个月的评估。IMG 完成了 970 次基于案例的讨论（CBD）、1741 次迷你临床检查练习（mini-CEX）和 1020 次多源反馈（MSF）评估。
来自 28 个国家（非洲、亚洲、欧洲、南美洲、南太平洋）的 103 名男性和 39 名女性候选人，在亨特新英格兰卫生区的城市和农村医院工作。
三种 WBA 工具的综合可靠性，以测量误差（SEM）表示。
在我们的 WBA 计划中，5 次 CBD 和 12 次 mini-CEX 评估的组合达到了 0.33 的 SEM，大于 0.26 的量表点阈值。将六个 MSF 结果添加到评估包中，将 SEM 降低至 0.24，这是足够精确的。
结合来自不同 WBA 评估工具的数据可以为评估 IMG 提供可接受的可靠性，前提是仔细选择 WBA 评估类型的面板，并且评估员经过校准。
