Yale University School of Medicine, Department of Medicine, New Haven, Connecticut.
Veterans Affairs Connecticut Healthcare System, Center of Excellence in Primary Care Education, West Haven, Connecticut.
Am J Pharm Educ. 2019 Jun;83(5):6435. doi: 10.5688/ajpe6435.
To develop a brief instrument for academic pharmacists or physicians to use in assessing postgraduate residents' knowledge of polypharmacy. Five clinicians used a modified Delphi process to create a 26-item multiple-choice test to assess knowledge of polypharmacy in geriatric primary care. The test was distributed to 74 participants: 37 internal medicine (MD) residents, six nurse practitioner (NP) residents, nine primary care attendings, 12 pharmacists and pharmacy residents, and 10 geriatrics attendings and fellows. Construct validity was assessed using factor analysis and item response theory. Overall group differences were examined using a Kruskal-Wallis test, and between group differences were assessed using the Wilcoxon rank sum test. The response rate for the survey was 89%. Factor analysis resulted in a one factor solution. Item response theory modeling yielded a 12-item and six-item test. For the 12-item test, the mean scores of geriatricians and pharmacists (88%) were higher than those of MD and NP residents (58%) and primary care attendings (61%). No differences were found between MD and NP residents and primary care attendings. Findings for the six-item test were similar. Both the 12-item and six-item versions of this polypharmacy test showed acceptable internal consistency and known groups validity and could be used in other academic settings. The similar scores between MD and NP residents and primary care attendings, which were significantly lower than scores for pharmacists and geriatricians, support the need for increased educational interventions.
为了开发一种简单的工具，让学术药师或医师在评估研究生住院医师对多种药物治疗的知识时使用。五位临床医生使用改良的 Delphi 流程创建了一个 26 项多项选择题测试，以评估老年初级保健中多种药物治疗的知识。该测试分发给 74 名参与者：37 名内科 (MD) 住院医师、6 名执业护士 (NP) 住院医师、9 名初级保健主治医生、12 名药剂师和药房住院医师以及 10 名老年病主治医生和研究员。使用因子分析和项目反应理论评估构念效度。使用 Kruskal-Wallis 检验评估总体组间差异，使用 Wilcoxon 秩和检验评估组间差异。调查的回复率为 89%。因子分析得出了一个单因素解决方案。项目反应理论建模得出了 12 项和 6 项测试。对于 12 项测试，老年病学家和药剂师的平均得分（88%）高于 MD 和 NP 住院医师（58%）和初级保健主治医生（61%）。MD 和 NP 住院医师与初级保健主治医生之间没有差异。六项测试的结果相似。这两种多种药物治疗测试的 12 项和 6 项版本都具有可接受的内部一致性和已知组有效性，可以在其他学术环境中使用。MD 和 NP 住院医师与初级保健主治医生的得分相似，明显低于药剂师和老年病学家的得分，这支持需要增加教育干预。
