Wise S, Stagg P L, Szucs R, Gay S, Mauger D, Hartman D
Department of Radiology, Penn State University/Penn State Geisinger Health System, Milton S. Hershey Medical Center 17033, USA.
Acad Radiol. 1999 Jan;6(1):66-71. doi: 10.1016/s1076-6332(99)80064-6.
The authors assessed the ability of faculty and residents to predict the ranked performance of residents on the American College of Radiology (ACR) In-Training Examination.
Radiology faculty at Penn State Geisinger Health System (PSGHS), the Medical College of Virginia (MCV), and the University of Virginia (UVA) and residents at PSGHS and MCV ranked the expected performances of residents taking the 1997 ACR In-Training Examination. Surveyed faculty and residents were blinded to the actual performances on the examination. Forty-nine residents took the examination (21 at PSGHS, 22 at MCV, six at UVA), and 37 faculty members (11 at PSGHS, 11 at MCV, 15 at UVA) participated in the study. Correlation analysis was performed to assess the agreement between the subjective and actual ranking of residents in each residency class.
Faculty were moderately accurate in the overall ranking of resident performances (r = 0.34). High levels of concordance for ranking individual residents correlated with accuracy in only certain cases. Differences in agreement and accuracy of the respondents existed between PSGHS and MCV (P = .0001 and .0014, respectively). The concordance of respondents increased significantly from the 1st- to the 2nd-year class at MCV (P = .0002), whereas accuracy increased significantly between these classes for the PSGHS (P = .042).
Faculty are only moderately successful in ranking resident performances on the ACR In-Training Examination, and a high level of agreement is not necessarily indicative of increased accuracy. The concordance and accuracy of subjective rankings differ among residency programs and classes.
作者评估了教员和住院医师预测住院医师在美国放射学会（ACR）住院医师培训考试中的排名表现的能力。
宾夕法尼亚州立大学盖辛格医疗系统（PSGHS）、弗吉尼亚医学院（MCV）和弗吉尼亚大学（UVA）的放射科教员以及PSGHS和MCV的住院医师对参加1997年ACR住院医师培训考试的住院医师的预期表现进行了排名。参与调查的教员和住院医师对考试的实际成绩并不知情。49名住院医师参加了考试（PSGHS有21名，MCV有22名，UVA有6名），37名教员（PSGHS有11名，MCV有11名，UVA有15名）参与了该研究。进行相关性分析以评估每个住院医师班级中主观排名与住院医师实际排名之间的一致性。
教员在总体评估住院医师表现方面的准确性一般（r = 0.34）。在某些特定情况下，对个别住院医师排名的高度一致性才与准确性相关。PSGHS和MCV的受访者在一致性和准确性方面存在差异（分别为P = 0.0001和0.0014）。MCV从第一年到第二年班级，受访者的一致性显著增加（P = 0.0002），而PSGHS在这些班级之间的准确性显著提高（P = 0.。
教员在对ACR住院医师培训考试中的住院医师表现进行排名时仅取得了一定程度的成功，高度一致性并不一定意味着准确性的提高。主观排名的一致性和准确性在不同的住院医师培训项目和班级之间存在差异。
