Park Young Soon, Chun Kyung Hee, Lee Kyeong Soo, Lee Young Hwan
Department of Medical Education, Konyang University College of Medicine, Daejeon, Korea.
Department of Preventive Medicine and Public Health, Yeungnam University College of Medicine, Daegu, Korea.
Yeungnam Univ J Med. 2021 Apr;38(2):118-126. doi: 10.12701/yujm.2020.00423. Epub 2020 Aug 6.
This study is an analysis of evaluator factors affecting physician-patient interaction (PPI) scores in clinical performance examination (CPX). The purpose of this study was to investigate possible ways to increase the reliability of the CPX evaluation.
The six-item Yeungnam University Scale (YUS), four-item analytic global rating scale (AGRS), and one-item holistic rating scale (HRS) were used to evaluate student performance in PPI. A total of 72 fourth-year students from Yeungnam University College of Medicine in Korea participated in the evaluation with 32 faculty and 16 standardized patient (SP) raters. The study then examined the differences in scores between types of scale, raters (SP vs. faculty), faculty specialty, evaluation experience, and level of fatigue as time passes.
There were significant differences between faculty and SP scores in all three scales and a significant correlation among raters' scores. Scores given by raters on items related to their specialty were lower than those given by raters on items out of their specialty. On the YUS and AGRS, there were significant differences based on the faculty's evaluation experience; scores by raters who had three to ten previous evaluation experiences were lower than others' scores. There were also significant differences among SP raters on all scales. The correlation between the YUS and AGRS/HRS declined significantly according to the length of evaluation time.
In CPX, PPI score reliability was found to be significantly affected by the evaluator factors as well as the type of scale.
本研究旨在分析临床技能考核（CPX）中影响医患互动（PPI）评分的评估者因素。本研究的目的是探索提高CPX评估可靠性的可能方法。
采用庆熙大学六项量表（YUS）、四项分析性整体评分量表（AGRS）和一项整体评分量表（HRS）来评估学生在PPI中的表现。韩国庆熙大学医学院的72名四年级学生参与了评估，评估者包括32名教员和16名标准化病人（SP）。该研究随后考察了量表类型、评估者（SP与教员）、教员专业、评估经验以及随着时间推移疲劳程度等因素对评分的影响。
在所有三个量表中，教员和SP的评分存在显著差异，且评估者之间的评分具有显著相关性。评估者对与其专业相关项目的评分低于对其专业以外项目的评分。在YUS和AGRS上，根据教员的评估经验存在显著差异；有三至十次先前评估经验的评估者给出的分数低于其他评估者。在所有量表上，SP评估者之间也存在显著差异。根据评估时间的长短，YUS与AGRS/HRS之间的相关性显著下降。
在CPX中，发现PPI评分的可靠性受到评估者因素以及量表类型的显著影响。
