Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania.
Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania; Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania.
J AAPOS. 2020 Dec;24(6):365.e1-365.e4. doi: 10.1016/j.jaapos.2020.08.012. Epub 2020 Dec 2.
The Pediatric Examination Assessment Rubric (PEAR) toolkit consists of an examination sheet and rubric designed to assess ophthalmology residents' performance on the pediatric eye examination. The purpose of this study was to evaluate the reliability of the PEAR toolkit.
Six ophthalmology residents (2 PGY-2, 4 PGY-3) at a single ACGME-accredited US program participated in 11 video-recorded pediatric ophthalmology patient encounters. Two pediatric ophthalmologists reviewed the videos and the residents' examination sheets to complete a PEAR evaluation. The inter-rater reliability of the rating for each of the 12 examination skills evaluated using PEAR was determined using kappa statistics, and reliability strength was categorized based on published guidelines (≤0, poor; 0-0.20, slight; 0.21-0.40, fair; 0.41-0.60, moderate; 0.41-0.60, substantial; 0.81-1.00, almost perfect).
Eleven video encounters were completed. Of the 12 examination skills evaluated using PEAR, 9 had kappa scores with strengths of moderate to almost perfect reliability. Two examination skills, Worth 4-Dot and alignment, showed fair reliability. A kappa score could not be calculated for stereoacuity because of the lack of variability among the evaluators' raw scores.
In our small sample of residents from a single institution, the PEAR toolkit showed inter-rater reliability.
儿科检查评估量表（PEAR）工具包由一份检查单和一份评估表组成，旨在评估眼科住院医师在儿科眼部检查中的表现。本研究的目的是评估 PEAR 工具包的可靠性。
在一个单一的 ACGME 认证的美国项目中，六名眼科住院医师（2 名 PGY-2，4 名 PGY-3）参与了 11 次视频记录的儿科眼科患者就诊。两名小儿眼科医生查看了视频和住院医师的检查单，以完成 PEAR 评估。使用 Kappa 统计评估使用 PEAR 评估的 12 项检查技能中的每一项的评分的组内可靠性，并根据已发表的指南对可靠性强度进行分类（≤0，差；0-0.20，轻微；0.21-0.40，一般；0.41-0.60，中等；0.41-0.60，良好；0.81-1.00，几乎完美）。
完成了 11 次视频就诊。使用 PEAR 评估的 12 项检查技能中，有 9 项具有中度至几乎完美可靠性的 Kappa 评分。两项检查技能， Worth 4-Dot 和对齐，显示出良好的可靠性。由于评估者原始分数缺乏变异性，立体视锐度的 Kappa 评分无法计算。
在我们来自单一机构的少量住院医师样本中，PEAR 工具包显示出组内可靠性。
