掌握学习标准设定方法比较。

A Comparison of Approaches for Mastery Learning Standard Setting.

机构信息

J.H. Barsuk is professor, Departments of Medicine and Medical Education, Northwestern University Feinberg School of Medicine, Chicago, Illinois. E.R. Cohen is research associate, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois. D.B. Wayne is vice dean for education and Dr. John Sherman Appleman Professor, Departments of Medicine and Medical Education, Northwestern University Feinberg School of Medicine, Chicago, Illinois. W.C. McGaghie is professor, Department of Medical Education, Northwestern University Feinberg School of Medicine, Chicago, Illinois. R. Yudkowsky is professor, Department of Medical Education, University of Illinois at Chicago College of Medicine, Chicago, Illinois.

出版信息

Acad Med. 2018 Jul;93(7):1079-1084. doi: 10.1097/ACM.0000000000002182.

DOI:10.1097/ACM.0000000000002182

PMID:29465449

Abstract

PURPOSE

Defensible minimum passing standards (MPSs) must be used to evaluate learner performance outcomes in health professions education. In this study, the authors compared the results of traditional Angoff and Hofstee standard-setting exercises with the Mastery Angoff and Patient-Safety approaches for central venous catheter (CVC) insertion skills examinations. The authors also evaluated how these standards affected the historical performance of residents who participated in a simulation-based mastery learning (SBML) curriculum for CVC insertion skills.

METHOD

In April and May 2015, 12 physicians with expertise in CVC insertion set MPSs for previously published internal jugular (IJ) and subclavian (SC) CVC insertion checklists using Angoff, Hofstee, Mastery Angoff, and Patient-Safety approaches. The resulting MPSs were compared using historical performance of internal medicine and emergency medicine residents who participated in CVC insertion SBML.

RESULTS

The MPSs were set as follows: Angoff: IJ 91% checklist items correct, SC 90%. Hofstee: IJ 88%, SC 90%. Mastery Angoff: IJ 98%, SC 98%. Patient-Safety: IJ 98%, SC 98%. Based on the historical performance of 143 residents assessed on IJ and SC insertion, applying the 98% MPS would result in additional practice and retesting of 55/123 residents (45%) who had previously passed the IJ examination and 36/130 residents (28%) who had passed the SC examination using the Angoff and Hofstee MPSs.

CONCLUSIONS

The Mastery Angoff and Patient-Safety standard-setting approaches resulted in higher CVC insertion SBML MPSs compared with traditional standard-setting methods. Further study should assess the impact of these more rigorous standards on patient outcomes.

摘要

目的

在医学专业教育中，必须使用可防御的最低通过标准（MPS）来评估学习者的表现。在这项研究中，作者比较了传统的安戈夫（Angoff）和霍夫斯特（Hofstee）标准设定练习与中央静脉导管（CVC）插入技能考试的精通安戈夫（Mastery Angoff）和患者安全方法的结果。作者还评估了这些标准如何影响参与 CVC 插入技能模拟基础精通学习（SBML）课程的住院医师的历史表现。

方法

2015 年 4 月至 5 月，12 名在 CVC 插入方面具有专业知识的医生使用安戈夫（Angoff）、霍夫斯特（Hofstee）、精通安戈夫（Mastery Angoff）和患者安全方法为之前发表的颈内（IJ）和锁骨下（SC）CVC 插入清单制定 MPS。使用参与 CVC 插入 SBML 的内科和急诊医学住院医师的历史表现来比较由此产生的 MPS。

结果

MPS 设定如下：安戈夫（Angoff）：IJ 清单项目正确 91%，SC 90%。霍夫斯特（Hofstee）：IJ 88%，SC 90%。精通安戈夫（Mastery Angoff）：IJ 98%，SC 98%。患者安全：IJ 98%，SC 98%。根据 143 名 IJ 和 SC 插入评估的住院医师的历史表现，如果应用 98%的 MPS，则会导致 55/123 名（45%）之前通过 IJ 考试和 36/130 名（28%）通过 SC 考试的住院医师额外练习和重新考试使用安戈夫（Angoff）和霍夫斯特（Hofstee）MPS。