B.N. Hasty was a surgical education fellow, Department of Surgery, Stanford University School of Medicine, Stanford, California, at the time of writing. She is currently a resident in general surgery, Loyola University Medical Center, Maywood, Illinois. J.N. Lau is professor of surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California. A. Tekian is professor and associate dean for international affairs, Department of Medical Education, University of Illinois, Chicago, Chicago, Illinois; ORCID: http://orcid.org/0000-0002-9252-1588. S.E. Miller was a fourth-year medical student, Stanford University School of Medicine, Stanford, California, at the time of writing. She is currently a resident in obstetrics and gynecology, Stanford University School of Medicine, Stanford, California. E.S. Shipper was a general surgery resident, University of Texas Health Science Center at San Antonio, San Antonio, Texas, at the time of writing. He is currently a research fellow, National Trauma Institute, San Antonio, Texas. S. Bereknyei Merrell is director of research, Goodman Surgical Education Center, and research scholar, Stanford-Surgery Policy Improvement Research & Education Center (S-SPIRE), Stanford University School of Medicine, Stanford, California. E.W. Lee was a surgical education fellow, Department of Surgery, Stanford University School of Medicine, Stanford, California. He is currently a resident in general surgery, Inova Fairfax Medical Campus, Falls Church, Virginia. Y.S. Park is associate professor and associate head, Department of Medical Education, University of Illinois, Chicago, Chicago, Illinois; ORCID: http://orcid.org/0000-0001-8583-4335.
Acad Med. 2020 Jan;95(1):129-135. doi: 10.1097/ACM.0000000000003007.
To examine the validity evidence for a scrub training knowledge assessment tool to demonstrate the utility and robustness of a multimodal, entrustable professional activity (EPA)-aligned, mastery learning scrub training curriculum.
Validity evidence was collected for the knowledge assessment used in the scrub training curriculum at Stanford University School of Medicine from April 2017 to June 2018. The knowledge assessment had 25 selected response items that mapped to curricular objectives, EPAs, and operating room policies. A mastery passing standard was established using the Mastery Angoff and Patient-Safety approaches. Learners were assessed pre curriculum, post curriculum, and 6 months after the curriculum.
From April 2017 to June 2018, 220 medical and physician assistant students participated in the scrub training curriculum. The mean pre- and postcurriculum knowledge scores were 74.4% (standard deviation [SD] = 15.6) and 90.1% (SD = 8.3), respectively, yielding a Cohen's d = 1.10, P < .001. The internal reliability of the assessment was 0.71. Students with previous scrub training performed significantly better on the precurriculum knowledge assessment than those without previous training (81.9% [SD = 12.6] vs 67.0% [SD = 14.9]; P < .001). The mean item difficulty was 0.74, and the mean item discrimination index was 0.35. The Mastery Angoff overall cut score was 92.0%.
This study describes the administration of and provides validity evidence for a knowledge assessment tool for a multimodal, EPA-aligned, mastery-based curriculum for scrub training. The authors support the use of scores derived from this test for assessing scrub training knowledge among medical and physician assistant students.
检验一种手术器械护士培训知识评估工具的效度证据，以展示斯坦福大学医学院多模式、可委托的专业活动（EPA）一致、掌握学习手术器械护士培训课程的实用性和稳健性。
2017 年 4 月至 2018 年 6 月，斯坦福大学医学院采集了手术器械护士培训课程中知识评估的效度证据。该知识评估有 25 个选择题，与课程目标、EPA 和手术室政策相对应。掌握通过标准采用掌握式安戈夫法和患者安全法建立。学习者在课程前、课程后和课程结束后 6 个月接受评估。
2017 年 4 月至 2018 年 6 月，220 名医学生和医师助理参加了手术器械护士培训课程。课程前后的平均知识得分分别为 74.4%（标准差 [SD] = 15.6）和 90.1%（SD = 8.3），Cohen's d = 1.10，P <.001。评估的内部可靠性为 0.71。有手术器械护士培训经历的学生在课程前知识评估中的表现明显优于没有培训经历的学生（81.9% [SD = 12.6] vs 67.0% [SD = 14.9]；P <.001）。平均项目难度为 0.74，平均项目区分度指数为 0.35。掌握式安戈夫整体通过分数为 92.0%。
本研究描述了一种多模式、EPA 一致、基于掌握的手术器械护士培训课程的知识评估工具的实施，并提供了其效度证据。作者支持在医学生和医师助理中使用该测试评估手术器械护士培训知识的分数。
