Department of Emergency Medicine, Dong-A University College of Medicine, Busan, Korea.
Department of Medical Education, Dong-A University College of Medicine, Busan, Korea.
J Educ Eval Health Prof. 2021;18:4. doi: 10.3352/jeehp.2021.18.4. Epub 2021 Mar 25.
In medical education, peer assessment is considered to be an effective learning strategy. Although several studies have examined agreement between peer and faculty assessments regarding basic life support (BLS), few studies have done so for advanced resuscitation skills (ARS) such as intubation and defibrillation. Therefore, this study aimed to determine the degree of agreement between medical students' and faculty assessments of ARS examinations.
This retrospective explorative study was conducted during the emergency medicine (EM) clinical clerkship of fourth-year medical students from April to July 2020. A faculty assessor (FA) and a peer assessor (PA) assessed each examinee's resuscitation skills (including BLS, intubation, and defibrillation) using a checklist that consisted of 20 binary items (performed or not performed) and 1 global proficiency rating using a 5-point Likert scale. The prior examinee assessed the next examinee after feedback and training as a PA. All 54 students participated in peer assessment. The assessments of 44 FA/PA pairs were analyzed using the intraclass correlation coefficient (ICC) and Gwet's first-order agreement coefficient.
The PA scores were higher than the FA scores (mean±standard deviation, 20.2±2.5 [FA] vs. 22.3±2.4 [PA]; P<0.001). The agreement was poor to moderate for the overall checklist (ICC, 0.55; 95% confidence interval [CI], 0.31 to 0.73; P<0.01), BLS (ICC, 0.19; 95% CI, -0.11 to 0.46; P<0.10), intubation (ICC, 0.51; 95% CI, 0.26 to 0.70; P<0.01), and defibrillation (ICC, 0.49; 95% CI, 0.23 to 0.68; P<0.01).
Senior medical students showed unreliable agreement in ARS assessments compared to faculty assessments. If a peer assessment is planned in skills education, comprehensive preparation and sufficient assessor training should be provided in advance.
在医学教育中，同伴评估被认为是一种有效的学习策略。尽管有几项研究已经检查了基本生命支持（BLS）方面的同伴评估和教师评估之间的一致性，但很少有研究针对高级复苏技能（ARS），如插管和除颤。因此，本研究旨在确定医学生和教师对 ARS 考试评估之间的一致性程度。
这是一项回顾性探索性研究，在 2020 年 4 月至 7 月期间进行，对象为四年级医学生的急诊医学（EM）临床实习。一名教师评估员（FA）和一名同伴评估员（PA）使用包含 20 个二进制项目（执行或未执行）的检查表和使用 5 点 Likert 量表的 1 个整体熟练程度评分，对每位考生的复苏技能（包括 BLS、插管和除颤）进行评估。前一位考生在反馈和培训后作为 PA 对下一位考生进行评估。所有 54 名学生都参加了同伴评估。使用组内相关系数（ICC）和 Gwet 一阶一致性系数分析了 44 对 FA/PA 的评估结果。
PA 评分高于 FA 评分（平均值±标准差，20.2±2.5[FA] vs. 22.3±2.4[PA]；P<0.001）。总体检查表（ICC，0.55；95%置信区间[CI]，0.31 至 0.73；P<0.01）、BLS（ICC，0.19；95%CI，-0.11 至 0.46；P<0.10）、插管（ICC，0.51；95%CI，0.26 至 0.70；P<0.01）和除颤（ICC，0.49；95%CI，0.23 至 0.68；P<0.01）的一致性为差到中度。
与教师评估相比，高年级医学生在 ARS 评估中表现出不可靠的一致性。如果计划在技能教育中进行同伴评估，则应提前进行全面的准备和充分的评估员培训。
