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本科医学教育中的非技术技能评估:一项重点 BEME 系统评价:BEME 指南第 54 号。

Non-technical skills assessments in undergraduate medical education: A focused BEME systematic review: BEME Guide No. 54.

机构信息

a Department of Evidence Synthesis and Systematic Review , University of Central Lancashire , Preston , UK.

b Section of Hospital Medicine , The University of Chicago Pritzker School of Medicine , Chicago , IL , USA.

出版信息

Med Teach. 2019 Jul;41(7):732-745. doi: 10.1080/0142159X.2018.1562166. Epub 2019 Feb 8.

Abstract

Consensus on how to assess non-technical skills is lacking. This systematic review aimed to evaluate the evidence regarding non-technical skills assessments in undergraduate medical education, to describe the tools used, learning outcomes and the validity, reliability and psychometrics of the instruments. A standardized search of online databases was conducted and consensus reached on included studies. Data extraction, quality assessment, and content analysis were conducted per Best Evidence in Medical Education guidelines. Nine papers met the inclusion criteria. Assessment methods broadly fell into three categories: simulated clinical scenarios, objective structured clinical examinations, and questionnaires or written assessments. Tools to assess non-technical skills were often developed locally, without reference to conceptual frameworks. Consequently, the tools were rarely validated, limiting dissemination and replication. There were clear themes in content and broad categories in methods of assessments employed. The quality of this evidence was poor due to lack of theoretical underpinning, with most assessments not part of normal process, but rather produced as a specific outcome measure for a teaching-based study. While the current literature forms a good starting position for educators developing materials, there is a need for future work to address these weaknesses as such tools are required across health education.

摘要

目前对于如何评估非技术技能尚未达成共识。本系统评价旨在评估本科医学教育中非技术技能评估的证据,描述所使用的工具、学习成果以及工具的有效性、可靠性和心理测量学特性。通过在线数据库进行了标准化搜索,并就纳入的研究达成了共识。根据医学教育最佳证据指南进行了数据提取、质量评估和内容分析。有 9 篇论文符合纳入标准。评估方法大致分为三类:模拟临床场景、客观结构化临床考试和问卷或书面评估。评估非技术技能的工具通常是在没有参考概念框架的情况下在当地开发的。因此,这些工具很少经过验证,限制了它们的传播和复制。所使用的评估方法在内容上有明确的主题,在方法上有广泛的类别。由于缺乏理论基础,这些证据的质量较差,大多数评估都不是正常过程的一部分,而是作为基于教学的研究的特定结果衡量标准而产生的。虽然当前的文献为教育工作者开发材料提供了一个良好的起点,但需要未来的工作来解决这些弱点,因为这些工具在整个健康教育中都是必需的。

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