Abu Dabrh Abd Moain, Waller Thomas A, Bonacci Robert P, Nawaz Anem J, Keith Joshua J, Agarwal Anjali, Merfeld John, Nordin Terri, Winscott Mary Michelle, Belda Thomas E, Murad Mohammad Hassan, Pantin Sally Ann L, Steinkraus Lawrence W, Grau Thomas J, Angstman Kurt B
Department of Family Medicine, Mayo Clinic Florida, Jacksonville, FL, USA.
Integrative Medicine and Health, Department of General Internal Medicine, Mayo clinic, Jacksonville, FL, USA.
BMC Med Educ. 2020 Oct 14;20(1):362. doi: 10.1186/s12909-020-02290-3.
Interpersonal and Communication Skills (ICS) and Professionalism milestones are challenging to evaluate during medical training. Paucity in proficiency, direction and validity evidence of assessment tools of these milestones warrants further research. We validated the reliability of the previously-piloted Instrument for Communication skills and Professionalism Assessment (InCoPrA) in medical learners.
This validity approach was guided by the rigorous Kane's Framework. Faculty-raters and standardized patients (SPs) used their respective InCoPrA sub-component to assess distinctive domains pertinent to ICS and Professionalism through multiple expert-built simulated-scenarios comparable to usual care. Evaluations included; inter-rater reliability of the faculty total score; the correlation between the total score by the SPs; and the average of the total score by two-faculty members. Participants were surveyed regarding acceptability, realism, and applicability of this experience.
Eighty trainees and 25 faculty-raters from five medical residency training sites participated. ICC of the total score between faculty-raters was generally moderate (ICC range 0.44-0.58). There was on average a moderate linear relationship between the SPs and faculty total scores (Pearson correlations range 0.23-0.44). Majority of participants ascertained receiving a meaningful, immediate, and comprehensive patient-faculty feedback.
This work substantiated that InCoPrA was a reliable, standardized, evidence-based, and user-friendly assessment tool for ICS and Professionalism milestones. Validating InCoPrA showed generally-moderate agreeability and high acceptability. Using InCoPrA also promoted engaging all stakeholders in medical education and training-faculty, learners, and SPs-using simulation-media as pathway for comprehensive feedback of milestones growth.
在医学培训期间，人际沟通技能（ICS）和职业素养里程碑的评估具有挑战性。这些里程碑评估工具在熟练度、指导和有效性证据方面的不足值得进一步研究。我们验证了先前试点的医学学习者沟通技能与职业素养评估工具（InCoPrA）的可靠性。
这种有效性方法以严格的凯恩框架为指导。教员评分者和标准化病人（SPs）使用各自的InCoPrA子组件，通过多个与常规护理相当的专家构建模拟场景，评估与ICS和职业素养相关的不同领域。评估包括：教员总分的评分者间信度；SPs总分之间的相关性；以及两名教员成员总分的平均值。就这种体验的可接受性、真实性和适用性对参与者进行了调查。
来自五个医学住院医师培训地点的80名学员和25名教员评分者参与了研究。教员评分者之间总分的组内相关系数（ICC）一般为中等（ICC范围0.44 - 0.58）。SPs和教员总分之间平均存在中等程度的线性关系（皮尔逊相关系数范围0.23 - 0.44）。大多数参与者确定收到了有意义、即时且全面的医患反馈。
这项工作证实了InCoPrA是用于ICS和职业素养里程碑的可靠、标准化、基于证据且用户友好的评估工具。验证InCoPrA显示出总体中等程度的一致性和高可接受性。使用InCoPrA还促进了医学教育和培训中的所有利益相关者——教员、学习者和SPs——通过模拟媒体参与，作为里程碑进展全面反馈的途径。
