Johnston James, Pinsk Maury
Department of Pediatrics & Child Health, Max Rady College of Medicine, University of Manitoba, FE009-840 Sherbrook St, Winnipeg, MB R3A 1S1 Canada.
Med Sci Educ. 2019 Dec 12;30(1):203-209. doi: 10.1007/s40670-019-00855-6. eCollection 2020 Mar.
The University of Manitoba's ambulatory pediatric clerkship transitioned to daily encounter cards (DECs) from single in-training evaluation reports (ITERs). The impact of this change on quality of student assessment was unknown. Using the validated Completed Clinical Evaluation Report Rating (CCERR) scale, we compared the assessment quality of the single ITER to the DEC-based system.
Block randomization was used to select from a cohort of ITER- and DEC-based assessments during equivalent points in clerkship training. Data were transcribed and anonymized and scored by two blinded raters using the CCERR.
Inter-rater reliability for total CCERR scores was substantive (> 0.6). Mean total CCERR score for the DEC cohort was significantly higher than for the ITER cohort (25.2 vs. 16.8, < 0.001), as were the mean scores for each item (2.81 vs. 1.86, < 0.05). Multivariate logistical regression supported the significant influence of assessment method on assessment quality.
There is improvement in the average quality of student assessments associated with the transition from an ITER-based system to a DEC-based system. However, the improvement to only average CCERR scores for the DEC cohort suggests an unmet need for faculty development.
曼尼托巴大学的门诊儿科实习从单一的培训期间评估报告(ITER)转变为每日会诊卡片(DEC)。这一变化对学生评估质量的影响尚不清楚。我们使用经过验证的完整临床评估报告评分(CCERR)量表,比较了单一ITER与基于DEC的系统的评估质量。
在实习培训的同等阶段,采用区组随机化方法从基于ITER和基于DEC的评估队列中进行选择。数据被转录、匿名化,并由两名盲法评分者使用CCERR进行评分。
CCERR总分的评分者间信度较高(>0.6)。基于DEC队列的CCERR总平均分显著高于基于ITER队列的平均分(25.2对16.8,<0.001),每个项目的平均分也是如此(2.81对1.86,<0.05)。多变量逻辑回归支持评估方法对评估质量的显著影响。
从基于ITER的系统转变为基于DEC的系统后,学生评估的平均质量有所提高。然而,基于DEC队列的CCERR平均分仅有所提高,这表明在教师发展方面仍有未满足的需求。