教学交接会影响后续评估吗？

Does Educational Handover Influence Subsequent Assessment?

机构信息

V. Dory was, when this study occurred, assistant professor, Department of Medicine, assessment specialist for undergraduate medical education, and core member, Centre for Medical Education, Faculty of Medicine, McGill University, Montreal, Quebec, Canada, and then assistant professor, General Practice, Institut de Recherche Santé et Société and Centre académique de médecine générale, Université catholique de Louvain, Brussels, Belgium. She is currently an educationalist, Department of General Practice, Université de Liège, Liège, Belgium; ORCID: https://orcid.org/0000-0002-5814-5654 .

D. Danoff is affiliate member, Institute of Health Sciences Education, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.

出版信息

Acad Med. 2021 Jan 1;96(1):118-125. doi: 10.1097/ACM.0000000000003528.

DOI:10.1097/ACM.0000000000003528

PMID:32496286

Abstract

PURPOSE

Educational handover (i.e., providing information about learners' past performance) is controversial. Proponents argue handover could help tailor learning opportunities. Opponents fear it could bias subsequent assessments and lead to self-fulfilling prophecies. This study examined whether raters provided with reports describing learners' minor weaknesses would generate different assessment scores or narrative comments than those who did not receive such reports.

METHOD

In this 2018 mixed-methods, randomized, controlled, experimental study, clinical supervisors from 5 postgraduate (residency) programs were randomized into 3 groups receiving no educational handover (control), educational handover describing weaknesses in medical expertise, and educational handover describing weaknesses in communication. All participants watched the same videos of 2 simulated resident-patient encounters and assessed performance using a shortened mini-clinical evaluation exercise form. The authors compared mean scores, percentages of negative comments, comments focusing on medical expertise, and comments focusing on communication across experimental groups using analyses of variance. They examined potential moderating effects of supervisor experience, gender, and mindsets (fixed vs growth).

RESULTS

Seventy-two supervisors participated. There was no effect of handover report on assessment scores (F(2, 69) = 0.31, P = .74) or percentage of negative comments (F(2, 60) = 0.33, P = .72). Participants who received a report indicating weaknesses in communication generated a higher percentage of comments on communication than the control group (63% vs 50%, P = .03). Participants who received a report indicating weaknesses in medical expertise generated a similar percentage of comments on expertise compared to the controls (46% vs 47%, P = .98).

CONCLUSIONS

This study provides initial empirical data about the effects of educational handover and suggests it can-in some circumstances-lead to more targeted feedback without influencing scores. Further studies are required to examine the influence of reports for a variety of performance levels, areas of weakness, and learners.

摘要

目的

教育交接（即提供学习者过去表现的信息）存在争议。支持者认为交接可以帮助定制学习机会。反对者则担心这可能会影响后续评估，并导致自我实现的预言。本研究旨在探讨向评分者提供描述学习者轻微弱点的报告是否会产生与未收到此类报告的评分者不同的评估分数或叙述性评论。

方法

在这项 2018 年的混合方法、随机、对照、实验研究中，来自 5 个研究生（住院医师）项目的临床主管被随机分为 3 组，分别为未接受教育交接（对照组）、描述医学专业弱点的教育交接和描述沟通弱点的教育交接。所有参与者观看了 2 个模拟住院医师-患者接触的视频，并使用缩短的迷你临床评估练习表格进行了表现评估。作者使用方差分析比较了实验组之间的平均分数、负面评论的百分比、关注医学专业的评论和关注沟通的评论。他们研究了主管经验、性别和思维模式（固定与成长）的潜在调节作用。

结果

共有 72 名主管参与了研究。交接报告对评估分数（F（2, 69）=0.31, P=.74）或负面评论的百分比（F（2, 60）=0.33, P=.72）均无影响。与对照组相比，收到报告表明沟通存在弱点的参与者生成的沟通相关评论的百分比更高（63%比 50%，P=.03）。收到报告表明医学专业存在弱点的参与者生成的与专业相关的评论百分比与对照组相似（46%比 47%，P=.98）。