Dawson-Saunders B, Mast T A, Finch W T, Konrad H R, Folse J R
Med Educ. 1984 Jan;18(1):31-5. doi: 10.1111/j.1365-2923.1984.tb01473.x.
Skills in reviewing medical charts have been demonstrated components of clinical competence related to knowledge base, level of clinical experience, and basic observational skills. A study of the generalizability of performance on chart review exercises, which controlled for knowledge in the content area, was undertaken to determine their potential in evaluating students' problem-solving ability. Results of the study indicate that the case specificity which has characterized simulated problem-solving tasks is largely case, rather than content, specificity: correlations between scores on single charts demonstrated no consistent relationships for measures of proficiency, efficiency, and diagnostic accuracy. However, averaging the scores on two charts and then computing correlations resulted in significant positive measures for both proficiency and efficiency. The effects of length and difficulty level on the generalizability of tests of problem-solving ability are areas suggested for future research.
病历审查技能已被证明是与知识库、临床经验水平和基本观察技能相关的临床能力组成部分。为了确定病历审查练习在评估学生解决问题能力方面的潜力，开展了一项针对病历审查练习表现可推广性的研究，该研究控制了内容领域的知识。研究结果表明，模拟解决问题任务所具有的病例特异性在很大程度上是病例特异性，而非内容特异性：单份病历得分之间的相关性在熟练程度、效率和诊断准确性测量方面未显示出一致关系。然而，将两份病历的得分平均后再计算相关性，结果显示熟练程度和效率方面均有显著的正相关指标。病历长度和难度水平对解决问题能力测试可推广性的影响是建议未来研究的领域。
