Khalifa Ahmed Khalifa, Hegazy Salah
Department of Prosthodontic, Mansoura Dental School, Mansoura University, Mansoura, Egypt.
J Educ Eval Health Prof. 2018;15:23. doi: 10.3352/jeehp.2018.15.23. Epub 2018 Sep 27.
It aimed to determine the agreement between two raters evaluating students at prosthodontic clinical practical exam integrated with directly observed procedural skills (DOPS).
A sample of 76 students was monitored by two raters to evaluate the process and the final registered maxillomandibular relation for completely edentulous patient in Mansoura Dental School, Egypt at practical exam of the Bachelor students on May 15, till June 28, 2017. Each registered relation was evaluated from total 60 marks subdivided to three score-categories: occlusal plane orientation (OPO), vertical dimension registration (VDR), and centric relation registration (CRR). The marks of each category included mark of DOPS. The marks of OPO and VDR for both raters were compared by graph method to measure reliability using the Bland and Altman analysis. The reliability of CRR marks was evaluated by Krippendorff's alpha ratio.
The results revealed similarity between raters for OPO (mean = 18.1) and closes of limits of agreement (0.73 and -0.78). For VDR, there were closeness of means (mean= 17.4 and 17.1 for examiner 1 and 2 respectively); with limits of agreement (2.7and-2.2). There was a strong correlation (Krippendorff's alpha ratio= 0.92; 95% CI [0.79-0.99]) among raters at evaluating CRR.
The two raters' evaluation of clinical traditional practical exam integrated with directly observed procedural skills revealed not to be different to evaluate candidate at the end of the clinical prosthodontic course. The limits of agreement between raters would be optimum at exclusion subjective evaluation parameters and complicated cases from examination procedures.
旨在确定两名评估者在对口腔修复临床实践考试(结合直接观察操作技能,即DOPS)中的学生进行评估时的一致性。
2017年5月15日至6月28日,在埃及曼苏拉牙科学院对76名本科学生进行实践考试时,由两名评估者对完全无牙患者的操作过程及最终记录的上下颌关系进行监测。每个记录的关系从总共60分中进行评估,分为三个评分类别:咬合平面定向(OPO)、垂直距离记录(VDR)和正中关系记录(CRR)。每个类别的分数包括DOPS分数。通过图形法比较两名评估者的OPO和VDR分数,使用布兰德-奥特曼分析来测量可靠性。CRR分数的可靠性通过克里彭多夫阿尔法系数进行评估。
结果显示,评估者在OPO方面具有相似性(均值 = 18.1),一致性界限较窄(0.73和 -0.78)。对于VDR,均值接近(评估者1和2的均值分别为17.4和17.1);一致性界限为(2.7和 -2.2)。评估者在评估CRR时具有很强的相关性(克里彭多夫阿尔法系数 = 0.92;95%置信区间[0.79 - 0.99])。
两名评估者对结合直接观察操作技能的临床传统实践考试的评估显示,在口腔修复临床课程结束时对考生的评估没有差异。在排除主观评估参数和复杂病例的考试程序后,评估者之间的一致性界限将达到最佳。