Assessing the reliability and validity of the mini-clinical evaluation exercise for internal medicine residency training
Assessing the reliability and validity of the mini-clinical evaluation exercise for internal medicine residency training
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DOI：
10.1097/00001888-200209000-00020
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发表时间：
2002-09-01
影响因子：
7.4
通讯作者：
Pangaro, LN
中科院分区：
文献类型：
--
作者：
Durning, SJ;Cation, LJ;Pangaro, LN
目的.小型临床评估演习，或小型CEX，评估居民的历史和体检技能。迄今为止，尚无研究评估mini-CEX（mCEX）评价格式的有效性。作者的目的是确定mCEX评估格式的信度和效度。23名第一年的居民在赖特帕特森医学中心在代顿，俄亥俄州，被纳入研究（学年1996-97，1997-98，和1998-99）。通过比较mCEX评分与标准美国内科医学委员会（ABIM）每月评估表（MEF）和美国医师学院-美国内科医学会培训考试（ITE）的相应部分的评分，确定该工具的有效性。所有的ABIM MEF均在无排除标准的情况下使用，包括未进行相应mCEX评价的月份的ABIM MEF。研究中的每位居民平均接受7次mCEX评估和12次ABIM MEF。在要求的168项mCEX评价中，对162项进行了研究。内部一致性。可靠性为90。发现以下各项具有统计学显著相关性：mCEX病史与ABIM病史; mCEX体格检查与ABIM体格检查; mCEX临床判断与ABIM临床判断、医疗护理、医学知识和ITE; mCEX人文属性与ABIM人文属性，以及mCEX总体临床能力与ABIM总体临床能力、医疗护理、医学知识和ITE。比较连续平均mCEX评分的方差分析没有产生显著差异。本研究表明mCEX是一种可行的、可靠的评价工具。mCEX评分与相应的ABIM MEF评分以及ITE之间的强相关性支持mCEX的有效性。
Purpose. The mini-chnical evaluation exercise, or mini-CEX, assesses residents' history and physical examination skills. To date, no study has assessed the validity of the mini-CEX (mCEX) evaluation format. The authors' objective was to determine the reliability and validity of the mCEX evaluation format.Method. Twenty-three first-year residents at WrightPatterson Medical Center in Dayton, Ohio, were included in the study (academic years 1996-97, 1997-98, and 1998-99). Validity of the instrument was determined by comparing mCEX scores with scores from corresponding sections of a modified version of the standard American Board of Internal Medicine's (ABIM's) monthly evaluation form (MEF) and the American College of Physicians-American Society of Internal Medicine In-Training Examination (ITE). All ABIM MEFs were used without exclusionary criteria, including ABIM MEFs from months where a corresponding mCEX evaluation was not performed.Results. Each resident in the study had an average of seven mCEX evaluations and 12 ABIM MEFs. Of the 168 required mCEX evaluations, 162 were studied. Internal consistency. reliability was .90. Statistically significant correlations were found for the following: mCEX history with ABIM history; mCEX physical exam with ABIM physical exam; mCEX clinical judgment with ABIM clinical judgment, medical care, medical knowledge, and the ITE; mCEX humanistic attributes with ABIM humanistic attributes, and mCEX overall clinical competence with ABIM overall clinical competence, medical care, medical knowledge, and the ITE. Analysis of variance comparing sequential mean mCEX scores yielded no significant difference.Conclusions. This study suggests that the mCEX is a feasible and reliable evaluation toot. The validity of the mCEX is supported by the strong correlations between mCEX scores and corresponding ABIM MEF scores as well as the ITE.