Wenrich M D, Carline J D, Giles L M, Ramsey P G
Department of Medicine, University of Washington School of Medicine, Seattle.
Acad Med. 1993 Sep;68(9):680-7. doi: 10.1097/00001888-199309000-00014.
To examine the feasibility and reliability of ratings completed by hospital-based registered nurses of the humanistic qualities, communication skills, and selected aspects of the clinical skills of practicing internists.
In 1988-1989, registered nurses who worked in the same 175 hospitals as 232 internists with admitting privileges at these hospitals rated the internists' performances. The nurses were selected from medicine floors, specialty floors, and intensive care units and/or critical care units, using lists provided by head nurses. A total of 1,877 rating questionnaires with 13 performance categories were collected (with a mean of 8.01 nurses per internist). The ratings were analyzed to determine measurement characteristics and the relationships of the nurses' demographic characteristics to the ratings. In addition, for each of ten performance categories for 152 of the internists, the average rating each internist received from nurses was compared with the average rating each internist received from peer physicians. Statistical analysis used Pearson correlations, canonical correlations, factor analyses, Student's t-tests, analysis of variance, and stepwise multiple regression. Finally, the internists themselves, including physicians who were not actually rated by the nurses, were asked to complete a brief questionnaire that included questions about their opinions of the use of nurses' ratings.
The nurses' ratings correlated moderately strongly with the peer physicians' ratings and had a common structure. However, the nurses' ratings were lower for several humanistic qualities, including respect, integrity, and responsibility, and their ratings were higher for medical knowledge and verbal communications. Across the 13 performance categories, approximately 10-15 ratings from nurses were needed to obtain a reliable assessment of an internist's humanistic qualities and communication skills. Many internists felt that nurses' ratings should be used equally with, or at least as a lesser contribution to, ratings by peer physicians of humanistic qualities and communication skills.
Nurses' ratings appear to provide a feasible and reliable method of evaluating the internists' communication skills and humanistic qualities, when used in conjunction with ratings by peer physicians.
检验医院注册护士对执业内科医生的人文素质、沟通技巧及临床技能某些方面进行评分的可行性和可靠性。
1988 - 1989年，在与232名具有住院特权的内科医生所在的175家相同医院工作的注册护士对这些内科医生的表现进行评分。护士从内科病房、专科病房以及重症监护病房中选取，依据护士长提供的名单确定。共收集了1877份包含13个表现类别的评分问卷（每位内科医生平均有8.01名护士评分）。对评分进行分析以确定测量特征以及护士人口统计学特征与评分之间的关系。此外，对于152名内科医生的十个表现类别中的每一项，将每位内科医生从护士处获得的平均评分与从同行医生处获得的平均评分进行比较。统计分析采用Pearson相关性分析、典型相关性分析、因子分析、Student t检验、方差分析和逐步多元回归。最后，要求内科医生本人，包括那些实际上未被护士评分的医生，填写一份简短问卷，其中包括关于他们对使用护士评分看法的问题。
护士的评分与同行医生的评分具有中等强度的相关性且结构相同。然而，护士对包括尊重、正直和责任感在内的若干人文素质的评分较低，而对医学知识和言语沟通的评分较高。在13个表现类别中，需要大约10 - 15名护士的评分才能可靠地评估内科医生的人文素质和沟通技巧。许多内科医生认为，在人文素质和沟通技巧方面，护士的评分应与同行医生的评分同等使用，或者至少作为同行医生评分的一个较小补充。
当与同行医生的评分结合使用时，护士的评分似乎为评估内科医生的沟通技巧和人文素质提供了一种可行且可靠的方法。
