Emergency Medicine, Stanford University, Stanford, CA, USA.
Women's Studies, Western University Faculty of Arts and Humanities Ringgold Standard Institution, London, ON, Canada.
Med Educ. 2021 Oct;55(10):1123-1130. doi: 10.1111/medu.14531. Epub 2021 May 19.
Individual assessment disregards the team aspect of clinical work. Team assessment collapses the individual into the group. Neither is sufficient for medical education, where measures need to attend to the individual while also accounting for interactions with others. Valid and reliable measures of interdependence are critical within medical education given the collaborative manner in which patient care is provided. Medical education currently lacks a consistent approach to measuring the performance between individuals working together as part of larger healthcare team. This review's objective was to identify existing approaches to measuring this interdependence.
Following Arksey & O'Malley's methodology, we conducted a scoping review in 2018 and updated it to 2020. A search strategy involving five databases located >12 000 citations. At least two reviewers independently screened titles and abstracts, screened full texts (n = 161) and performed data extraction on twenty-seven included articles. Interviews were also conducted with key informants to check if any literature was missing and assess that our interpretations made sense.
Eighteen of the twenty-seven articles were empirical; nine conceptual with an empirical illustration. Eighteen were quantitative; nine used mixed methods. The articles spanned five disciplines and various application contexts, from online learning to sports performance. Only two of the included articles were from the field of Medical Education. The articles conceptualised interdependence of a group, using theoretical constructs such as collaboration synergy; of a network, using constructs such as degree centrality; and of a dyad, using constructs such as synchrony. Both descriptive (eg social network analysis) and inferential (eg multi-level modelling) approaches were described.
Efforts to measure interdependence are scarce and scattered across disciplines. Multiple theoretical concepts and inconsistent terminology may be limiting programmatic work. This review motivates the need for further study of measurement techniques, particularly those combining multiple approaches, to capture interdependence in medical education.
个体评估忽略了临床工作的团队方面。团队评估将个体融入群体。对于医学教育来说，这两种方法都不够充分，因为医学教育需要关注个体，同时也要考虑与他人的互动。在协作提供患者护理的方式下，医学教育中需要有可靠且有效的相互依存关系的衡量标准。由于目前医学教育缺乏一种一致的方法来衡量作为更大的医疗团队一部分的个体之间的合作表现，因此本次审查的目的是确定现有的衡量这种相互依存关系的方法。
我们遵循 Arksey 和 O'Malley 的方法，于 2018 年进行了范围审查，并于 2020 年进行了更新。我们的搜索策略涉及五个数据库，共找到了 12000 多个引文。至少有两名评审员独立筛选标题和摘要、筛选全文（n=161）并对 27 篇纳入文章进行数据提取。还对主要知情人进行了访谈，以检查是否有遗漏的文献，并评估我们的解释是否合理。
27 篇文章中有 18 篇是实证的；9 篇是概念性的，有实证说明。18 篇是定量的；9 篇使用混合方法。这些文章涵盖了五个学科领域和各种应用环境，从在线学习到运动表现。纳入的文章中只有两篇来自医学教育领域。这些文章使用协作协同作用等理论概念来概念化群体的相互依存关系；使用度中心性等构造来概念化网络的相互依存关系；使用同步等构造来概念化对子的相互依存关系。描述性（例如社会网络分析）和推论性（例如多层次建模）方法都有描述。
衡量相互依存关系的努力很少，且分散在各个学科领域。多个理论概念和不一致的术语可能限制了计划工作。本综述促使人们需要进一步研究测量技术，特别是那些结合多种方法的技术，以捕捉医学教育中的相互依存关系。
