Department of Internal Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Department of Health Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile.
Postgrad Med J. 2019 Feb;95(1120):96-101. doi: 10.1136/postgradmedj-2018-136187. Epub 2019 Feb 20.
Clinical rotations are an essential part of Internal Medicine (IM) residency programmes, where curricular objectives are carried out. To our knowledge, there are no validated instruments to assess IM clinical rotations. Our objective was to develop an instrument for residents to assess the quality of clinical rotations in an IM residency programme, and to test the psychometric properties of the instrument. A mixed methodology was used, including qualitative and quantitative phases. Items were proposed by a group of experts based on previously identified residency needs, followed by a quantitative phase to generate consensus among educators and residents to define which items would be included in the instrument (Delphi panel). After generating the instrument, psychometric tests were performed to assess construct validity (factor analysis) and reliability (Raykov's reliability coefficient). We obtained a 15-item instrument after two Delphi rounds: (). Sixty-two residents answered 428 surveys using a Likert scale during 7 months (response rate 98.9%). The median score was 4.3 (IQR 3.9-4.7) (scale from 1 to 5). The factor analysis showed two domains in the clinical rotation assessment: (1) teaching and care activities; (2) evaluation and feedback. The instrument is reliable with Raykov's reliability coefficient of 0.86. Also, Raykov's reliability coefficient for the domains were 0.89 and 0.83, respectively. The IMPRINT-15 instrument is a bi-dimensional, valid and reliable questionnaire to evaluate the perceived quality by residents of the IM clinical rotations. Also, it constitutes the first validated instrument in this field worldwide.
临床轮转是内科住院医师培训计划的重要组成部分,在该计划中完成课程目标。据我们所知,目前还没有经过验证的工具可以评估内科临床轮转。我们的目标是开发一种用于评估内科住院医师培训计划中临床轮转质量的工具,并测试该工具的心理测量学特性。本研究采用混合方法,包括定性和定量两个阶段。根据先前确定的住院医师需求,由一组专家提出项目,然后进行定量阶段,以在教育者和住院医师之间达成共识,确定哪些项目将包含在工具中(德尔菲小组)。生成工具后,进行心理测量测试以评估构建效度(因子分析)和信度(Raykov 可靠性系数)。经过两轮德尔菲法,我们得到了一个包含 15 个项目的工具:()。在 7 个月的时间里,有 62 名住院医师使用李克特量表回答了 428 份调查(应答率为 98.9%)。中位数评分为 4.3(IQR 3.9-4.7)(评分范围为 1 至 5)。因子分析显示临床轮转评估中有两个领域:(1)教学和护理活动;(2)评估和反馈。该工具具有可靠性,Raykov 可靠性系数为 0.86。此外,两个领域的 Raykov 可靠性系数分别为 0.89 和 0.83。IMPRINT-15 工具是一种二维、有效且可靠的问卷,用于评估住院医师对内科临床轮转的感知质量。此外,它还是全球范围内第一个经过验证的该领域的工具。