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发展并初步验证一种用于部分活髓切断术的客观结构化临床技能评估(OSATS)。

Development and preliminary validation of an Objective Structured Assessment of Technical Skills (OSATS) for a partial pulpotomy procedure.

机构信息

University of Bretagne Occidentale, Brest University Hospital, Brest, France.

University of Bretagne Occidentale, EA7479, SPURBO, Brest, France.

出版信息

Int Endod J. 2023 Aug;56(8):1011-1021. doi: 10.1111/iej.13938. Epub 2023 Jun 6.

Abstract

AIM

To develop an Objective Structured Assessment of Technical Skills (OSATS) tool for partial pulpotomy and to preliminary assess the validity of this tool. Secondary objectives were to check internal consistency as well as the interrater reliability of this specific checklist and to compare it with the previously validated global rating score (GRS).

METHODOLOGY

The study assessed three groups of dental participants (mix of practitioners or students) possessing differing levels of clinical experience (7 novices, 7 intermediates, 7 experts), during a partial pulpotomy procedure on a simulated tooth with deep caries, using a bespoke procedure-specific checklist (PSC) and the GRS. Two independent examiners received the study participants in groups of two, in order to be able to directly observe their actions and grade the different steps of the procedure from 1 to 5 on the PSC and GRS. The internal validity of the specific checklist was assessed using a Cronbach's alpha test. As the construct validity of such a tool can be determined when the tool differentiates performance based on the level of experience, the total score of the PSC of the three groups (e.g., novice group, intermediate group, experienced group) were compared using the Kruskal-Wallis and post-hoc Mann-Whitney pairwise U test. The total scores of the GRS were also analysed in the same manner. A correlation test (Correlation Matrices Test) was carried out for the entire sample between the specific checklist and the GRS (on total score). The intraclass correlation coefficient was used to measure the degree of agreement between the two evaluators. The statistical analysis was performed with XLSTAT® and Statistica® (significance p = .05).

RESULTS

The partial pulpotomy specific checklist graded from one to five demonstrated good internal consistency (0.86) and a good interrater reliability (0.91), a correct construct validity (p generally < .05) and a good positive correlation with the validated GRS (r = .92).

CONCLUSIONS

To address the need to develop education in vital pulp treatment, and more specifically the technical skills assessment of partial pulpotomy, an OSATS-specific checklist was developed and preliminary validated. The checklist will need to be validated in larger cohorts.

摘要

目的

开发一种用于部分活髓切断术的客观结构化临床技能评估(OSATS)工具,并初步评估该工具的有效性。次要目标是检查该特定检查表的内部一致性和评分者间信度,并将其与先前验证的总体评分(GRS)进行比较。

方法

本研究评估了三组牙科参与者(从业者或学生的混合体),他们具有不同的临床经验水平(7 名新手、7 名中级、7 名专家),在模拟深龋牙齿上进行部分活髓切断术时,使用特定于操作的定制检查表(PSC)和 GRS。两名独立的检查者将研究参与者分成两人一组,以便能够直接观察他们的操作,并根据 PSC 和 GRS 将该操作的不同步骤从 1 分到 5 分进行评分。使用 Cronbach's alpha 测试评估特定检查表的内部有效性。由于当工具根据经验水平区分性能时可以确定工具的结构有效性,因此使用 Kruskal-Wallis 和事后曼-惠特尼 U 检验比较了三组(例如新手组、中级组、经验丰富组)的 PSC 总分。GRS 的总分也以同样的方式进行分析。对整个样本进行了特定检查表和 GRS(总分)之间的相关性测试(相关矩阵测试)。使用组内相关系数(ICC)来衡量两位评估者之间的一致性程度。统计分析使用 XLSTAT®和 Statistica®(显著水平 p = .05)进行。

结果

从 1 分到 5 分的部分活髓切断术特定检查表显示出良好的内部一致性(0.86)和良好的评分者间信度(0.91),正确的结构有效性(p 一般 < .05)和与经过验证的 GRS 具有良好的正相关性(r = .92)。

结论

为了解决在牙髓治疗教育中开发的需求,特别是部分活髓切断术的技术技能评估,开发了一种 OSATS 特定的检查表并进行了初步验证。该检查表将需要在更大的队列中进行验证。

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