Shekar Revathi, George Brian C, Bohnen Jordan D, Villa Alessandro
Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2018 Sep;126(3):246-251. doi: 10.1016/j.oooo.2018.05.017. Epub 2018 May 29.
The aim of this study was to evaluate a smartphone application, SIMPL, to optimize faculty guidance and oral medicine residents' performance, and to measure resident-faculty agreement for performance and supervision levels.
Raters used the 5-level "Performance" scale to assess resident's readiness for independent practice and the 4-level Zwisch scale to assess faculty guidance, between June 2016 and June 2017. Junior residents were trainees with less than 18 months of training, and senior residents had more than 18 months of training. Descriptive statistics were used to analyze supervision and autonomy. Performance and supervision agreement was estimated as percentage-agreement and measured using κ and 95% confidence intervals.
A total of 660 evaluations were performed by 6 residents and 6 faculty members. Senior residents received higher performance scores compared with junior residents (P for trend < .01). In terms of complexity of cases and level of supervision, there were no significant differences between juniors and seniors (P = .69 and P = .39, respectively). Residents were "practice ready" or greater than for 80% cases. Residents received meaningful autonomy for 64.8% cases. Faculty-resident concordance was 86.1% for performance (with κ of 0.77 [95% CI 66.1%-87.6%]) and 92.4% for supervision (with κ of 0.84 [95% CI 80%-88%]).
SIMPL can feasibly be used for real-time assessment of residents' performance and autonomy.
本研究旨在评估一款智能手机应用程序SIMPL，以优化教师指导和口腔医学住院医师的表现，并衡量住院医师与教师在表现和监督水平上的一致性。
在2016年6月至2017年6月期间，评估者使用5级“表现”量表评估住院医师独立执业的准备情况，并使用4级Zwisch量表评估教师指导情况。初级住院医师是培训时间少于18个月的受训人员，高级住院医师的培训时间超过18个月。使用描述性统计分析监督和自主性。表现和监督的一致性以百分比一致性估计，并使用κ值和95%置信区间进行测量。
6名住院医师和6名教师共进行了660次评估。与初级住院医师相比，高级住院医师获得了更高的表现分数（趋势P<0.01）。在病例复杂性和监督水平方面，初级和高级住院医师之间没有显著差异（分别为P = .69和P = .39）。住院医师对80%以上的病例“准备好执业”。住院医师在64.8%的病例中获得了有意义的自主权。教师与住院医师在表现方面的一致性为86.1%（κ值为0.77 [95% CI 66.1%-87.6%]），在监督方面的一致性为92.4%（κ值为0.84 [95% CI 80%-88%]）。
SIMPL可切实用于实时评估住院医师的表现和自主性。
