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"影子" OSCE 考官。一项横断面研究比较了"影子"考官与原始 OSCE 考官模式。

"Shadow" OSCE examiner. A cross-sectional study comparing the "shadow" examiner with the original OSCE examiner format.

机构信息

Divisao de Clinica Medica, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, SP, BR.

Departamento de Clinica Medica, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.

出版信息

Clinics (Sao Paulo). 2019 Nov 11;74:e1502. doi: 10.6061/clinics/2019/e1502. eCollection 2019.

Abstract

OBJECTIVES

Feedback is a powerful learning tool, but a lack of appropriate feedback is a very common complaint from learners to teachers. To improve opportunities for feedback on objective structured clinical examinations (OSCEs), a modified examiner role, termed the "shadow" examiner, was tested. This study aims to present and analyze comparisons between the "shadow" examiner and the original OSCE examiner format.

METHODS

In 2011, experiments were carried out with modifications to the examiner's role to define the "shadow" examiner format. From February 2012 to May 2014, research was conducted with 415 6th-year medical students. Of these students, 316 were randomly assigned to assessments by both "shadow" and "fixed" examiners. Pearson correlation analysis with linear regression, Student's t-tests and Bland-Altman plots were the statistical methods used to compare the assessment modes. To strengthen the analysis, checklist items were classified by domain.

RESULTS

High correlations between the "shadow" and "fixed" examiners' global scores were observed. The results of the analysis of specific domains demonstrated higher correlations for cognitive scores and lower correlations for affective scores. No statistically significant differences between the mean examiner global scores were found. The Bland-Altman analysis showed that the "shadow" examiners' affective scores were significantly higher than those of the "fixed" examiners, but the magnitude of this difference was small.

CONCLUSION

The modified examiner role did not lead to any important bias in the students' scores compared with the original OSCE examiner format. This new strategy may provide important insights for formative assessments of clinical performance.

摘要

目的

反馈是一种强有力的学习工具,但学习者向教师反馈缺乏适当的反馈是一个非常普遍的问题。为了增加客观结构化临床考试(OSCE)中反馈的机会,测试了一种修改后的考官角色,称为“影子”考官。本研究旨在介绍和分析“影子”考官与原始 OSCE 考官模式之间的比较。

方法

2011 年,对考官的角色进行了修改,以定义“影子”考官模式,进行了实验。2012 年 2 月至 2014 年 5 月,对 415 名 6 年级医学生进行了研究。其中 316 名学生被随机分配给“影子”和“固定”考官的评估。使用 Pearson 相关分析与线性回归、学生 t 检验和 Bland-Altman 图来比较评估模式。为了加强分析,检查表项目按域分类。

结果

“影子”和“固定”考官的全球评分之间存在高度相关性。特定域分析的结果表明认知评分的相关性更高,情感评分的相关性更低。平均考官全球评分之间没有统计学差异。Bland-Altman 分析表明,“影子”考官的情感评分明显高于“固定”考官,但这种差异的幅度很小。

结论

与原始 OSCE 考官模式相比,修改后的考官角色并没有导致学生成绩出现任何重要偏差。这种新策略可能为临床表现的形成性评估提供重要的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d960/6827324/f7ca8f00769f/cln-74-e1502-g001.jpg

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