Stillman P L, Swanson D B, Smee S, Stillman A E, Ebert T H, Emmel V S, Caslowitz J, Greene H L, Hamolsky M, Hatem C
Ann Intern Med. 1986 Nov;105(5):762-71. doi: 10.7326/0003-4819-105-5-762.
Current techniques do not provide a reproducible, reliable, or valid basis for assessing clinical skills. The need for large-scale direct observation and standardized assessment procedures has precluded development of better techniques. A project using standardized patients presenting with common clinical problems evaluated the skills of 336 internal medicine residents at 14 New England residency programs in 1289 standardized patient and resident encounters. Results indicated that reproducible assessment of the clinical skills could be achieved in approximately 1 day of testing time using standardized patients. Resident performance improved with years of training, and senior residents and those from programs with stronger reputations performed better and were more homogeneous in ability. Low correlations between standardized-patient-based measures of clinical skills and other evaluation techniques suggested that standardized patients provided unique information. Reactions of residents and faculty to standardized-patient-based evaluations were favorable.
当前的技术无法为评估临床技能提供可重复、可靠或有效的基础。对大规模直接观察和标准化评估程序的需求阻碍了更好技术的发展。一个项目利用呈现常见临床问题的标准化病人，在14个新英格兰住院医师培训项目中，对336名内科住院医师进行了1289次标准化病人与住院医师的接触评估。结果表明，使用标准化病人，在大约1天的测试时间内可以实现对临床技能的可重复评估。住院医师的表现随着培训年限的增加而提高，高级住院医师以及来自声誉较高项目的住院医师表现更好，能力也更趋一致。基于标准化病人的临床技能测量与其他评估技术之间的低相关性表明标准化病人提供了独特的信息。住院医师和教员对基于标准化病人的评估反应良好。
