Department of Innovation in Medical Education, University of Ottawa, Ottawa, Canada.
Department of Medicine, University of Ottawa, Ottawa, Canada.
Med Teach. 2020 Jan;42(1):46-51. doi: 10.1080/0142159X.2019.1652260. Epub 2019 Aug 20.
It is a doctrine that OSCE checklists are not sensitive to increasing levels of expertise whereas rating scales are. This claim is based primarily on a study that used two psychiatry stations and it is not clear to what degree the finding generalizes to other clinical contexts. The purpose of our study was to reexamine the relationship between increasing training and scoring instruments within an OSCE. A 9-station OSCE progress test was administered to Internal Medicine residents in post-graduate years (PGY) 1-4. Residents were scored using checklists and rating scales. Standard scores from three administrations (27 stations) were analyzed. Only one station produced a result in which checklist scores did not increase as a function of training level, but the rating scales did. For 13 stations, scores increased as a function of PGY equally for both checklists and rating scales. Checklist scores were as sensitive to the level of training as rating scales for most stations, suggesting that checklists can capture increasing levels of expertise. The choice of which measure is used should be based on the purpose of the examination and not on a belief that one measure can better capture increases in expertise.
它是这样一种学说，即 OSCE 清单对专业水平的提高不敏感，而评分量表则是敏感的。这一说法主要基于一项使用两个精神病学站的研究，而且尚不清楚该发现在多大程度上推广到其他临床环境。我们的研究目的是重新检验 OSCE 内培训与评分工具之间的关系。在 PGY1-4 的内科住院医师中进行了 9 站 OSCE 进展测试。住院医师使用清单和评分量表进行评分。对三个（27 个站）管理的标准分数进行了分析。只有一个站的结果表明，清单分数没有随着培训水平的提高而增加，而评分量表则是如此。对于 13 个站，清单和评分量表的评分都随着 PGY 水平的提高而增加。对于大多数站来说，清单分数与评分量表一样敏感地反映了培训水平，这表明清单可以捕捉到专业水平的提高。选择使用哪种衡量标准应该基于考试的目的，而不是基于一种认为一种衡量标准可以更好地捕捉专业水平提高的信念。
