一种用于急诊医学模拟训练中技术技能客观结构化评估的新型全球评分量表的开发。
Development of a novel global rating scale for objective structured assessment of technical skills in an emergency medical simulation training.
作者信息
Zoller Andreas, Hölle Tobias, Wepler Martin, Radermacher Peter, Nussbaum Benedikt L
机构信息
Medical Faculty, Ulm University, Ulm, Germany.
Institute of Anaesthesiological Pathophysiology and Process Engineering, University Hospital Ulm, Ulm, Germany.
出版信息
BMC Med Educ. 2021 Mar 25;21(1):184. doi: 10.1186/s12909-021-02580-4.
BACKGROUND
Medical simulation trainings lead to an improvement in patient care by increasing technical and non-technical skills, procedural confidence and medical knowledge. For structured simulation-based trainings, objective assessment tools are needed to evaluate the performance during simulation and the learning progress. In surgical education, objective structured assessment of technical skills (OSATS) are widely used and validated. However, in emergency medicine and anesthesia there is a lack of validated assessment tools for technical skills. Thus, the aim of the present study was to develop and validate a novel Global Rating Scale (GRS) for emergency medical simulation trainings.
METHODS
Following the development of the GRS, 12 teams of different experience in emergency medicine (4th year medical students, paramedics, emergency physicians) were involved in a pre-hospital emergency medicine simulation scenario and assessed by four independent raters. Subsequently, interrater reliability and construct validity of the GRS were analyzed. Moreover, the results of the GRS were cross-checked with a task specific check list. Data are presented as median (minimum; maximum).
RESULTS
The GRS consists of ten items each scored on a 5-point Likert scale yielding a maximum of 50 points. The median score achieved by novice teams was 22.75 points (17;30), while experts scored 39.00 points (32;47). The GRS overall scores significantly discriminated between student-guided teams and expert teams of emergency physicians (p = 0.005). Interrater reliability for the GRS was high with a Kendall's coefficient of concordance W ranging from 0.64 to 0.90 in 9 of 10 items and 0.88 in the overall score.
CONCLUSION
The GRS represents a promising novel tool to objectively assess technical skills in simulation training with high construct validity and interrater reliability in this pilot study.
背景
医学模拟培训通过提高技术和非技术技能、操作信心及医学知识，改善患者护理。对于基于结构化模拟的培训，需要客观评估工具来评估模拟过程中的表现和学习进展。在外科教育中，客观结构化技术技能评估（OSATS）被广泛应用且经过验证。然而，在急诊医学和麻醉学领域，缺乏经过验证的技术技能评估工具。因此，本研究的目的是开发并验证一种用于急诊医学模拟培训的新型整体评分量表（GRS）。
方法
在GRS开发完成后，12支不同经验水平的急诊医学团队（四年级医学生、护理人员、急诊医生）参与了一次院前急诊医学模拟场景，并由四名独立评分者进行评估。随后，分析了GRS的评分者间信度和结构效度。此外，还使用特定任务清单对GRS的结果进行了交叉核对。数据以中位数（最小值；最大值）表示。
结果
GRS由十个项目组成，每个项目采用5分李克特量表评分，最高可得50分。新手团队的中位数得分是22.75分（17；30），而专家团队的得分是39.00分（32；47）。GRS的总体得分在学生指导团队和急诊医生专家团队之间有显著差异（p = 0.005）。GRS的评分者间信度较高，10个项目中有9个项目的肯德尔和谐系数W在0.64至0.90之间，总体得分的肯德尔和谐系数W为0.88。
结论
在本初步研究中，GRS是一种很有前景的新型工具，可用于客观评估模拟培训中的技术技能，具有较高的结构效度和评分者间信度。
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