Clinical work sampling
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OBJECTIVE: Existing systems of in-training evaluation (ITE) have been criticized as being unreliable and invalid methods for assessing student performance during clinical education. The purpose of this study was to assess the feasibility, reliability, and validity of a clinical work sampling (CWS) approach to ITE. This approach focused on the following: (1) basing performance data on observed behaviors, (2) using multiple observers and occasions, (3) recording data at the time of performance, and (4) allowing for a feasible system to receive feedback.
PARTICIPANTS: Sixty-two third-year University of Ottawa students were assessed during their 8-week internal medicine inpatient experience.
MEASUREMENTS AND MAIN RESULTS: Four performance rating forms (Admission Rating Form, Ward Rating Form, Multidisciplinary Team Rating Form, and Patient’s Rating Form) were introduced to document student performance. Voluntary participation rates were variable (12%–64%) with patients excluded from the analysis because of low response rate (12%). The mean number of evaluations per student per rotation (19) exceeded the number of evaluations needed to achieve sufficient reliability. Reliability coefficients were high for the Ward Form (.86) and the Admission Form (.73) but not for the Multidisciplinary Team (.22) Form. There was an examiner effect (rater leniency), but this was small relative to real differences between students. Correlations between the Ward Form and the Admission Form were high (.47), while those with the Multidisciplinary Team Form were lower (.37 and .26, respectively). The CWS approach ITE was considered to be content valid by expert judges.
CONCLUSIONS: The collection of ongoing performance data was reasonably feasible, reliable, and valid.
- Hull, AL, Hodder, S, Berger, B (1995) Validity of three clinical performance assessments of internal medicine clerks. Acad Med 70: pp. 517-22 CrossRef
- Short, JP (1993) The importance of strong evaluation standards and procedures in training residents. Acad Med 68: pp. 522-5 CrossRef
- Phelan, S (1993) Evaluation of the noncognitive professional traits of medical students. Acad Med 68: pp. 799-803 CrossRef
- Hunt, DD (1992) Functional and dysfunctional characteristics of the prevailing model of clinical evaluation systems in North American medical schools. Acad Med 67: pp. 254-9 CrossRef
- Gray, JD (1996) Global rating scales in residency education. Acad Med 71: pp. S55-S63 CrossRef
- Kaplan, CB, Centor, RM (1990) The use of nurses to evaluate houseofficers’ humanistic behavior. J Gen Intern Med 5: pp. 410-4 CrossRef
- Dauphinee, D (1995) Assessing clinical performance: Where do we stand and what might we expect?. JAMA 274: pp. 741-3 CrossRef
- Vleuten, CPM, Norman, GR, Graaff, E (1991) Pitfalls in the pursuit of objectivity: issues of reliability. Med Educ 25: pp. 110-8
- Maxim, BR, Dielman, TE (1987) Dimensionality, internal consistency and interrater reliability of clinical performance ratings. Med Educ 27: pp. 130-7 CrossRef
- Stillman, PL (1991) Positive effects of a clinical performance assessment program. Acad Med 66: pp. 481-3 CrossRef
- Turnbull, J, Gray, J, MacFadyen, J (1998) Improving in-training evaluation programs. J Gen Intern Med 13: pp. 317-23 CrossRef
- Irby, DM, Milam, S (1989) The legal context for evaluating and dismissing medical students and residents. Acad Med 64: pp. 639-43 CrossRef
- Stone, AA, Shiffman, S (1994) Ecological momentary assessment (EMA) in behavioral medicine. Ann Beh Med 16: pp. 199-202
- Fleiss, J, Shrout, PE (1978) Approximate interval estimation for a certain inter-class correlation coefficient. Psychometrika 43: pp. 259-62 CrossRef
- Streiner, DL, Norman, GR (1995) Health Measurement Scales: A Practical Guide to their Development and Use. Oxford University Press, Oxford, U.K.
- Ramsey, PG, Carline, JD, Blank, LL, Wenrich, MD (1996) Feasibility of hospital-based use of peer ratings to evaluate the performances of practicing physicians. Acad Med 71: pp. 364-70 CrossRef
- Ramsey, PG, Wenrich, MD, Carline, JD, Inui, TS, Larson, EB, Logerfo, JP (1993) Use of peer ratings to evaluate physician performance. JAMA 269: pp. 1655-60 CrossRef
- Butterfield, PS, Mazzaferri, EL (1991) New rating form for use by nurses in assessing residents’ humanistic behavior. J Gen Intern Med 6: pp. 155-61 CrossRef
- CanMEDS 2000 Project. Skills for the new millennium. Ann RCPSC 29: pp. 206-16
- Clinical work sampling
Journal of General Internal Medicine
Volume 15, Issue 8 , pp 556-561
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