整体评分标准与分析性评分标准在医学生临床能力评估中的比较。
Holistic rubric vs. analytic rubric for measuring clinical performance levels in medical students.
机构信息
Department of Medical Education, Pusan National University School of Medicine, 49, Busandaehak-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea.
Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, 49, Busandaehak-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea.
出版信息
BMC Med Educ. 2018 Jun 5;18(1):124. doi: 10.1186/s12909-018-1228-9.
BACKGROUND
Task-specific checklists, holistic rubrics, and analytic rubrics are often used for performance assessments. We examined what factors evaluators consider important in holistic scoring of clinical performance assessment, and compared the usefulness of applying holistic and analytic rubrics respectively, and analytic rubrics in addition to task-specific checklists based on traditional standards.
METHODS
We compared the usefulness of a holistic rubric versus an analytic rubric in effectively measuring the clinical skill performances of 126 third-year medical students who participated in a clinical performance assessment conducted by Pusan National University School of Medicine. We conducted a questionnaire survey of 37 evaluators who used all three evaluation methods-holistic rubric, analytic rubric, and task-specific checklist-for each student. The relationship between the scores on the three evaluation methods was analyzed using Pearson's correlation. Inter-rater agreement was analyzed by Kappa index. The effect of holistic and analytic rubric scores on the task-specific checklist score was analyzed using multiple regression analysis.
RESULTS
Evaluators perceived accuracy and proficiency to be major factors in objective structured clinical examinations evaluation, and history taking and physical examination to be major factors in clinical performance examinations evaluation. Holistic rubric scores were highly related to the scores of the task-specific checklist and analytic rubric. Relatively low agreement was found in clinical performance examinations compared to objective structured clinical examinations. Meanwhile, the holistic and analytic rubric scores explained 59.1% of the task-specific checklist score in objective structured clinical examinations and 51.6% in clinical performance examinations.
CONCLUSION
The results show the usefulness of holistic and analytic rubrics in clinical performance assessment, which can be used in conjunction with task-specific checklists for more efficient evaluation.
背景
任务特定检查表、整体评分表和分析评分表常用于绩效评估。我们研究了评估者在整体评分临床绩效评估时认为重要的因素，并比较了分别应用整体和分析评分表以及在传统标准基础上增加任务特定检查表的分析评分表的有用性。
方法
我们比较了整体评分表和分析评分表在有效测量 126 名参加釜山国立大学医学院临床绩效评估的三年级医学生的临床技能表现方面的有用性。我们对使用所有三种评估方法（整体评分表、分析评分表和任务特定检查表）对每个学生进行评估的 37 名评估者进行了问卷调查。使用 Pearson 相关分析分析了三种评估方法之间的相关性。使用 Kappa 指数分析了评分者之间的一致性。使用多元回归分析分析了整体和分析评分表分数对任务特定检查表分数的影响。
结果
评估者认为准确性和熟练程度是客观结构化临床考试评估的主要因素，病史采集和体格检查是临床绩效考试评估的主要因素。整体评分表分数与任务特定检查表和分析评分表分数高度相关。与客观结构化临床考试相比，在临床绩效考试中发现的一致性相对较低。同时，整体和分析评分表分数在客观结构化临床考试中解释了任务特定检查表分数的 59.1%，在临床绩效考试中解释了 51.6%。
结论
结果表明整体和分析评分表在临床绩效评估中的有用性，可以与任务特定检查表一起用于更有效的评估。
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