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内科查房：可托付专业活动（EPA）观察清单的验证

Ward rounds in internal medicine: Validation of an Entrustable Professional Activity (EPA) observation checklist.

作者信息

Schmelter Valerie, März Esther, Adolf Christian, Wölfel Teresa L, Lottspeich Christian, Fischer Martin R, Schmidmaier Ralf

机构信息

Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Germany.

Klinikum der Universität München, Medizinische Klinik und Poliklinik IV, München, Germany.

出版信息

GMS J Med Educ. 2018 May 15;35(2):Doc17. doi: 10.3205/zma001164. eCollection 2018.

DOI:10.3205/zma001164
PMID:29963607
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6022584/
Abstract

Ward rounds serve a crucial daily activity in hospitals. Building on the Entrustable Professional Activity "Conducting internal medicine ward rounds" consisting of ten competencies and 25 corresponding activities, this study aims at assessing content and external validity of an observation checklist for this EPA. A focus group aimed at content validation of the checklist. Five participants therefore evaluated it with respect to comprehensiveness and comprehensibility. To investigate external validity, 14 authentic ward rounds were video-taped and rated by two raters with the adapted observation checklist in terms of the appearance of certain activities in the videos. After some adaptions, participants of the focus group agreed on a checklist consisting of nine competencies, 25 activities and 110 examples of observable behaviours supporting content validity. External validity was studied by using the observation checklist for ratings of ward round videos. The checklist was regarded as a valuable tool to structure observation. Along with the high frequencies of observed behaviour and interrater-reliability, external validity can be assumed. The first scientifically developed comprehensive observation checklist for the EPA is presented. The checklist is a valuable tool for providing elaborated feedback in undergraduate and graduate medical education. Focussing on multi-institutional validation and the cut offs of the checklist to determine the levels of entrustment are recommended for future research.

摘要

查房是医院日常的一项关键活动。本研究以包含十项能力和25项相应活动的“进行内科查房”可托付专业活动为基础，旨在评估该可托付专业活动观察清单的内容效度和外部效度。一个焦点小组旨在对该清单进行内容效度验证。因此，五名参与者对其全面性和可理解性进行了评估。为了调查外部效度，对14次实际查房进行了录像，并由两名评估者使用经过调整的观察清单，根据视频中某些活动的出现情况进行评分。经过一些调整后，焦点小组的参与者商定了一份由九项能力、25项活动和110项可观察行为示例组成的清单，以支持内容效度。通过使用观察清单对查房视频进行评分来研究外部效度。该清单被视为构建观察的宝贵工具。鉴于观察行为的高频率和评估者间的可靠性，可以假定其具有外部效度。本文介绍了首个科学开发的针对该可托付专业活动的全面观察清单。该清单是在本科和研究生医学教育中提供详细反馈的宝贵工具。建议未来的研究聚焦于多机构验证以及确定托付水平的清单临界值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43ad/6022584/39c3884ae80e/JME-35-17-t-002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43ad/6022584/ad0116981e1f/JME-35-17-t-001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43ad/6022584/39c3884ae80e/JME-35-17-t-002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43ad/6022584/ad0116981e1f/JME-35-17-t-001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43ad/6022584/39c3884ae80e/JME-35-17-t-002.jpg

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