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医学教育中药物治疗能力的结构化口腔临床评估:七个领域的效度和信度分析研究

Structured oral clinical assessment for pharmacotherapy competencies in medical education: a study of validity and reliability analyses of seven domains.

作者信息

Purba Abdul Khairul Rizki, Perdanakusuma David Sontani, Mustika Arifa, Fens Tanja, Postma Maarten Jacobus

机构信息

Medical Education Master Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.

Division of Pharmacology and Therapy, Department of Anatomy Histology and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.

出版信息

Korean J Med Educ. 2025 Sep;37(3):331-343. doi: 10.3946/kjme.2025.345. Epub 2025 Aug 28.

Abstract

PURPOSE

To develop and validate a structured oral clinical assessment (SOCA) tool to evaluate pharmacotherapy competencies among medical students during clinical clerkships.

METHODS

The instrument was designed around seven core pharmacotherapy domains. A total of 30 pharmacology experts participated in the face and content validity assessments. The cognitive complexity was evaluated using Bloom's taxonomy. Nine trained examiners assessed 77 clerkship students using the SOCA tool. Construct validity was tested using Spearman correlation, whereas inter-rater reliability was analyzed using Cohen's kappa and Krippendorff's alpha. Internal consistency was assessed using Cronbach's alpha.

RESULTS

All items showed strong content validity (item-level content validity index and face validity index=1.00). Most questions reflected moderate to high cognitive complexity (Bloom's C2-C5). Construct validity was supported by significant domain-total score correlations (r=0.406-0.750; p<0.05). Inter-rater reliability was substantial (kappa=0.651-0.830; Krippendorff's alpha=0.639-0.834), and internal consistency was acceptable (Cronbach's alpha=0.759).

CONCLUSION

The SOCA tool has strong validity and reliability for evaluating pharmacotherapy competence through oral clinical examination. It offers a structured, feasible alternative to existing formats and has the potential for broader use following external validation.

摘要

目的

开发并验证一种结构化口腔临床评估(SOCA)工具,以评估临床实习期间医学生的药物治疗能力。

方法

该工具围绕七个核心药物治疗领域设计。共有30名药理学专家参与了表面效度和内容效度评估。使用布鲁姆分类法评估认知复杂性。九名经过培训的考官使用SOCA工具对77名实习学生进行评估。使用斯皮尔曼相关性检验结构效度,而使用科恩kappa系数和克里彭多夫阿尔法系数分析评分者间信度。使用克朗巴赫阿尔法系数评估内部一致性。

结果

所有项目均显示出很强的内容效度(项目级内容效度指数和表面效度指数=1.00)。大多数问题反映出中度到高度的认知复杂性(布鲁姆的C2 - C5)。显著的领域总分相关性支持了结构效度(r = 0.406 - 0.750;p < 0.05)。评分者间信度较高(kappa = 0.651 - 0.830;克里彭多夫阿尔法系数 = 0.639 - 0.834),内部一致性可接受(克朗巴赫阿尔法系数 = 0.759)。

结论

SOCA工具通过口腔临床检查评估药物治疗能力具有很强的效度和信度。它为现有形式提供了一种结构化、可行的替代方案,并且在外部验证后有更广泛使用的潜力。

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