Medical College of Wisconsin, Wauwatosa, Wis.
Medical College of Wisconsin, Wauwatosa, Wis.
Acad Pediatr. 2021 Apr;21(3):569-574. doi: 10.1016/j.acap.2020.09.015. Epub 2020 Oct 7.
Training in patient- and family-centered care is endorsed by the American Academy of Pediatrics (AAP) and the Accreditation Council for Graduate Medical Education (ACGME) for learners. The AAP recommends patient- and family-centered rounds (PFCR) during inpatient care. The PEA-21 (21-item Presenter Empowerment Action checklist) was developed to evaluate presenter behavior during PFCR.
To gather validity evidence for the PEA-21 in evaluating third year medical student and intern presentations during PFCR in the domains of Data Accuracy, Communication Skills, Assessment and Plan Formation, and Family Interaction.
A 24-month prospective cohort study of students and interns presenting on PFCR. Content, response process, internal structure, and relationship with other variables were assessed.
Data were collected from 101 rounds (758 individual patient encounters), both on pediatric subspecialty and hospital medicine teams. Presenters included third- and fourth-year medical students and interns in pediatrics, internal medicine-pediatrics, and family-medicine. Intraclass correlations between observers ranged from 0.5 to 0.72. Internal consistency showed α >0.7 for 3 of 4 domains. Interns scored higher than students across domains (P< .01), but students' scores improved throughout their rotations (d = 0.2-0.8). Both groups performed lowest in the Family Interaction Domain.
The PEA-21 showed strong validity properties including content, response process, internal structure, and relationship with other variables and can be used by educators to assess learners' skill levels and provide formative feedback to both medical students and interns. Targeted efforts are needed to improve skills within the Family Interaction Domain for both medical students and interns.
以患者和家庭为中心的培训得到了美国儿科学会（AAP）和研究生医学教育认证委员会（ACGME）的认可，适用于学习者。AAP 建议在住院患者护理期间进行以患者和家庭为中心的查房（PFCR）。PEA-21（21 项演讲者赋权行为清单）是为了评估 PFCR 期间演讲者的行为而开发的。
在数据准确性、沟通技巧、评估和计划制定以及家庭互动等领域，为评估医学生和住院医师在 PFCR 中的演讲表现，收集 PEA-21 的有效性证据。
对在 PFCR 中进行演讲的医学生和住院医师进行了为期 24 个月的前瞻性队列研究。评估了内容、反应过程、内部结构以及与其他变量的关系。
共收集了 101 轮（758 例患者）的数据，涉及儿科专科和医院医学团队。演讲者包括儿科、内科-儿科和家庭医学的三年级和四年级医学生和住院医师。观察者之间的组内相关系数范围为 0.5 至 0.72。4 个领域中有 3 个领域的内部一致性α值>0.7。住院医师在所有领域的得分均高于医学生（P<0.01），但学生的得分在整个轮转过程中有所提高（d=0.2-0.8）。两组在家庭互动领域的得分最低。
PEA-21 具有很强的有效性，包括内容、反应过程、内部结构以及与其他变量的关系，可以被教育工作者用来评估学习者的技能水平，并为医学生和住院医师提供形成性反馈。需要有针对性地努力提高医学生和住院医师在家庭互动领域的技能。
