Department of Medicine (Division of Physical Medicine & Rehabilitation) and The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
Department of Educational Studies, University of South Carolina, College of Education, University of South Carolina, Wardlaw College, Columbia, South Carolina.
J Surg Educ. 2021 Sep-Oct;78(5):1666-1675. doi: 10.1016/j.jsurg.2021.03.014. Epub 2021 Jun 3.
Most work-place based assessment relies on physician supervisors making observations of residents. Many areas of performance are not directly observed by physicians but rather by other healthcare professionals, most often nurses. Assessment of resident performance by nurses is captured with multi-source feedback tools. However, these tools combine the assessments of nurses with other healthcare professionals and so their perspective can be lost. A novel tool was developed and implemented to assess resident performance on a hospital ward from the perspective of the nurses.
Through a nominal group technique, nurses identified dimensions of performance that are reflective of high-quality physician performance on a hospital ward. These were included as items in the Ottawa Resident Observation Form for Nurses (O-RON). The O-RON was voluntarily completed during an 11-month period. Validity evidence related to quantitative and qualitative data was collected.
The Orthopedic Surgery Residency Program at the University of Ottawa.
49 nurses on the Orthopedic Surgery wards at The Ottawa Hospital (tertiary care).
The O-RON has 15 items rated on a 3-point frequency scale, one global judgment yes/no question regarding whether they would want the resident on their team and a space for comments. 1079 O-RONs were completed on 38 residents. There was an association between the response to the global judgment question and the frequency of concerns (p < 0.01). With 8 forms per resident, the reliability of the O-RON was 0.80. Open-ended responses referred to aspects of interpersonal skills, responsiveness, dependability, communication skills, and knowledge.
The O-RON demonstrates promise as a work-place based assessment tool to provide residents and training programs with feedback on aspects of their performance on a hospital ward through the eyes of the nurses. It appears to be easy to use, has solid evidence for validity and can provide reliable data with a small number of completed forms.
大多数基于工作场所的评估依赖于医师主管对住院医师进行观察。许多绩效领域并未被医师直接观察到，而是由其他医疗保健专业人员（通常是护士）观察到。护士使用多源反馈工具对住院医师的绩效进行评估。然而，这些工具将护士的评估与其他医疗保健专业人员的评估结合在一起，因此可能会失去护士的视角。开发并实施了一种新工具，从护士的角度评估住院医师在医院病房的表现。
通过名义小组技术，护士确定了反映住院医师在医院病房高质量表现的绩效维度。这些维度被纳入护士对住院医师观察表（O-RON）中。在 11 个月的时间里，自愿填写 O-RON。收集了与定量和定性数据相关的有效性证据。
渥太华大学骨科住院医师培训计划。
渥太华医院骨科病房的 49 名护士（三级保健）。
O-RON 有 15 个项目，采用 3 分频率量表进行评分，一个关于是否愿意让住院医师加入他们团队的全局判断是/否问题，以及一个评论空间。对 38 名住院医师完成了 1079 份 O-RON。全球判断问题的回答与关注频率之间存在关联（p<0.01）。每个住院医师 8 份表格，O-RON 的可靠性为 0.80。开放式回复提到了人际交往技巧、响应性、可靠性、沟通技巧和知识等方面。
O-RON 作为一种基于工作场所的评估工具具有潜力，通过护士的视角为住院医师及其培训计划提供有关其在医院病房表现的反馈。它似乎易于使用，具有坚实的有效性证据，并可以在完成的表格数量较少的情况下提供可靠的数据。
