Henry S B, Holzemer W L
Department of Mental Health, Community and Administrative Nursing, University of California, San Francisco 94143-0608.
Comput Nurs. 1993 Jan-Feb;11(1):29-34.
The purpose of this study was to explore the relationship between computer-based clinical simulation performance and two commonly used methods of evaluation: cognitive examination and self-evaluation of expertise. The convenience sample of 68 critical care nurses completed the Basic Knowledge Assessment Tool for Critical Care (BKAT), a cardiovascular self-assessment tool (CST), and two computer-based clinical simulations requiring the management of myocardial infarction patients with tachydysrhythmias (atrial flutter and ventricular tachycardia). Simulation performance was measured by proficiency score and patient outcome (live/die). Proficiency on the atrial simulation was significantly correlated with knowledge as measured by the BKAT (r = 0.46, p 0.001) and with self-evaluation of clinical expertise (r = 0.32, p = 0.008). Atrial patient outcome was also significantly correlated with the BKAT (r = 0.28, p = 0.006) and the CST score (r = 0.22, p = 0.036). However, in the ventricular simulation only proficiency score and self-evaluation of expertise were significantly correlated (r = 0.24, p = 0.049). The modest relationships found in this study may indicate that, while clinical simulation performance is related to knowledge and self-evaluation of expertise, the constructs measured are not synonymous. This evidence provides support for the use of clinical simulations as an adjunct to other methods of evaluation.
认知测试和专业自我评估。68名重症监护护士的便利样本完成了重症监护基础知识评估工具（BKAT）、心血管自我评估工具（CST），以及两个基于计算机的临床模拟，模拟要求对患有快速性心律失常（心房扑动和室性心动过速）的心肌梗死患者进行管理。模拟表现通过熟练度得分和患者结局（存活/死亡）来衡量。心房模拟的熟练度与BKAT测量的知识显著相关（r = 0.46，p < 0.001），与临床专业自我评估也显著相关（r = 0.32，p = 0.008）。心房患者结局也与BKAT显著相关（r = 0.28，p = 0.006）和CST得分显著相关（r = 0.22，p = 0.036）。然而，在心室模拟中，只有熟练度得分和专业自我评估显著相关（r = 0.24，p = 0.049）。本研究中发现的适度关系可能表明，虽然临床模拟表现与知识和专业自我评估有关，但所测量的结构并非同义词。这一证据为将临床模拟用作其他评估方法的辅助手段提供了支持。
