住院医师培训评估中两种跨专业协作工具的一致性和分析质量

Karen Roper, Andrew Nelson, Shannon Sampson
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摘要

背景:许多医学院正在重新调整他们的培训计划,以培养以患者为中心、以团队为基础的合作护理的跨专业协作(IPC)能力,并需要评估计划的影响。目的:确定用于评估住院医师培训计划对IPC影响的两种自我报告工具的适当性。研究设计:为了评估仪器和项目目标之间的一致性,采用调查矩阵方法将每个仪器的目标结构(在技术报告中证明,验证文献和项目内容)与陈述的评估需求进行比较。为了评估仪器产生信息数据的能力,采用了Rasch测量方法。数据集:对跨专业协作能力获得调查(ICCAS)和对医疗团队的态度(AtHCT)的调查结果进行分析。研究人群:20多名不同培训阶段的住院医师。结果测量:工具项目与ipcc相关结果的比较;项目测量功能的Rasch分析。结果:ICCAS是IPC行为变化的一个有充分证据的评估。与项目目标的一致性很高。然而,Rasch的分析显示,考虑到居民的能力水平,项目难度较低。大约一半的受访者表示,他们的能力水平高于最难题目的目标能力水平。此外,缺乏“随机性”的回答(例如,过度选择“适度同意”的回答选项)表明调查疲劳或缺乏参与度。现有文献也支持AtHCT在评估医疗团队工作态度变化方面的有效性。然而,该仪器并不符合我们的培训计划的目标,即增加在跨专业团队中工作的信心和能力,而不是这样做的兴趣。Rasch的分析显示,虽然一些子量表比其他子量表表现得更好,但同样存在项目目标问题(例如,在干预前,超过50%的学生强烈支持“护理质量”子量表上的所有项目)和可能的调查疲劳。结论:尽管有
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Alignment and analytic quality of two interprofessional collaboration tools for a residency training evaluation
Context: Many medical schools are retooling their training programs to cultivate competencies in interprofessional collaboration (IPC) for patient-centered, team-based collaborative care and have a need to evaluate program impact. Objective: Determine the appropriateness of two self-report instruments used to evaluate a residency training program’s impact on IPC. Study Design: To assess alignment between the instruments and program goals, a survey matrixing approach compared each instrument’s targeted constructs (evidenced in technical reports, validating literature and item content) to stated evaluation needs. To assess the instruments’ abil ity to produce informative data, a Rasch measurement approach was used. Dataset: Survey responses were analyzed from the Interprofessional Collaborative Competencies Attainment Survey (ICCAS) and the Attitudes Towards Health Care Teams (AtHCT). Population studied: Over 20 residents at varying training stages. Outcome Measures: Comparison of instrument items to IPC-related outcomes; Rasch analysis of item measurement functioning. Results: The ICCAS is a well evidenced assessment of change in IPC behaviors. Alignment with program goals was high. However, Rasch analysis revealed that item difficulty was low given residents’ ability levels. Roughly half of all respondents reported an ability level above the targeted ability level of the most difficult item. Also , a lack of “randomness” in responses (e.g., over -selection of “Moderately agree” response option) indicated survey fatigue or lack of engagement. The extant literature also supported the AtHCT’s validity in assessing change in attitudes toward working in healthcare teams. However, the instrument was not well-aligned with our training program’s goal of increasing confidence and abilities to work in interprofessional teams — rather than interest in doing so. Rasch analysis revealed that while some subscales performed better than others, there was again issues with item targeting (e.g., in pre-intervention, over 50% of students strongly endorsed all items on the “Quality of Care” subscale) and possible survey fatigue. Conclusion: Despite having a
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