Kastner L, Gore E, Novack A H
J Pediatr. 1984 Jun;104(6):814-8. doi: 10.1016/s0022-3476(84)80473-4.
We compared pediatric residents' psychosocial attitude, personality, and in-training examination (American Board of Pediatrics) scores with faculty evaluations of the residents' clinical performance (clinical skills, medical knowledge, interpersonal skills and relationship with other staff) in inpatient, outpatient, and intensive care settings. We found no relationship between psychosocial attitudes and the in-training examination scores or among aggregate faculty ratings, attitudes, and examination scores, but faculty ratings grouped by setting yielded more discriminating results. On inpatient rotations, cognitive knowledge (as reflected by in-training examination scores) was positively correlated with faculty ratings. On intensive care and outpatient rotations, knowledge did not correlate with faculty ratings. Residents' attitudes favoring a psychosocial approach to medical practice were associated with positive evaluations on outpatient rotations but with negative evaluations on intensive care rotations. Psychosocial attitudes seemed to be determined by the social orientation of the resident's personality styles. Our results emphasize the importance of clinical setting to faculty rating and suggest that valued resident characteristics vary by setting. These findings have significant implications for both improving the clinical evaluation of residents and creating a better understanding of the interaction of personality, attitude, and cognitive variables in rated clinical performance.
我们将儿科住院医师的心理社会态度、个性以及培训期间考试（美国儿科学会）成绩，与教员对住院医师在住院、门诊和重症监护环境中的临床表现（临床技能、医学知识、人际技能以及与其他工作人员的关系）评估进行了比较。我们发现心理社会态度与培训期间考试成绩之间，以及教员综合评分、态度和考试成绩之间均无关联，但按环境分类的教员评分产生了更具区分性的结果。在住院轮转中，认知知识（如培训期间考试成绩所反映的）与教员评分呈正相关。在重症监护和门诊轮转中，知识与教员评分不相关。住院医师对采用心理社会方法进行医疗实践的态度，在门诊轮转中与积极评价相关，但在重症监护轮转中与消极评价相关。心理社会态度似乎由住院医师个性风格的社会取向所决定。我们的结果强调了临床环境对教员评分的重要性，并表明受重视的住院医师特征因环境而异。这些发现对于改进住院医师的临床评估以及更好地理解个性、态度和认知变量在评定临床绩效中的相互作用具有重要意义。
