Use of a 360-degree evaluation in the outpatient setting: the usefulness of nurse, faculty, patient/family, and resident self-evaluation.
Use of a 360-degree evaluation in the outpatient setting: the usefulness of nurse, faculty, patient/family, and resident self-evaluation.
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DOI：
10.4300/jgme-d-10-00013.1
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发表时间：
2010-09-01
影响因子：
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通讯作者：
Steiner, Michael J
中科院分区：
文献类型：
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作者：
Chandler, Nicole;Henderson, Gavin;Steiner, Michael J
背景：传统上，教职员工在没有患者、家属、护士或住院医师本人参与的情况下，对住院医师的专业精神和人际交往能力进行评估。我们研究的目的是使用医学研究生教育认证委员会(ACGME)建议的“360度评估”来确定非教职员工对住院医师的专业精神和人际交往技能的评分是否与教师评分不同。方法：儿科住院医师在为期5周的医院住院医师连续性诊所登记。患者/家属(P/F)、教员(MD[医学博士])、护士(RN[注册护士])和住院医生自己(SELF)在每次临床会议后通过使用带有5分Likert量表的有效10个项目的问卷来完成针对评估者的评估。对每份问卷的平均Likert评分进行统计。每种类型的评分者的平均Likert量表分数通过使用方差分析、文本和适当的配对比较来比较。结果：共完成对66名居民的823项评价(符合条件的居民总数为69人，参与率为95%)。所有评估者对住院医生的评分都很高(平均Likert评分范围为4.4至4.9)。然而，MD和RN对居民的评分高于P/F(平均分：MD，4.77，SD[标准差]，0.32；RN，4.85，SD，0.30；P/F，4.53，SD，0.96；P<；0.0001)。MD和RN得分也高于居民自评得分，但自评得分与P/F得分无显著差异(MD和RN的居民平均得分为4.44，SD为0.43；P& = 为0.0001，P/F为0.19)。所有评分者组合之间的相关系数在-0.21到0.21之间，没有统计学意义。结论：我们的研究发现居民的专业精神和人际交往能力得到了较高的评分。然而，医疗团队的不同成员对居民的评分不同，而且评分没有相关性。我们的结果为360度评估的潜在价值提供了证据。
BACKGROUND: Faculty have traditionally evaluated resident physician professionalism and interpersonal skills without input from patients, family members, nurses, or the residents themselves. The objective of our study was to use "360-degree evaluations," as suggested by the Accreditation Council for Graduate Medical Education (ACGME), to determine if nonfaculty ratings of resident professionalism and interpersonal skills differ from faculty ratings.METHODS: Pediatrics residents were enrolled in a hospital-based resident continuity clinic during a 5-week period. Patient/families (P/Fs), faculty (MD [doctor of medicine]), nurses (RNs [registered nurses]), and residents themselves (self) completed evaluator-specific evaluations after each clinic session by using a validated 10-item questionnaire with a 5-point Likert scale. The average Likert score was tallied for each questionnaire. Mean Likert scale scores for each type of rater were compared by using analysis of variance, text with pair-wise comparisons when appropriate. Agreement between rater types was measured by using the Pearson correlation.RESULTS: A total of 823 evaluations were completed for 66 residents (total eligible residents, 69; 95% participation). All evaluators scored residents highly (mean Likert score range, 4.4 to 4.9). However, MDs and RNs scored residents higher than did P/Fs (mean scores: MD, 4.77, SD [standard deviation], 0.32; RN, 4.85, SD, 0.30; P/F, 4.53, SD, 0.96; P < .0001). MD and RN scores also were higher than residents' self-evaluation scores, but there was no difference between self-scores and P/F scores (average resident self-score, 4.44, SD, 0.43; P < .0001 compared to MD and RN; P = .19 compared to P/F). Correlation coefficients between all combinations of raters ranged from -0.21 to 0.21 and none were statistically significant.CONCLUSION: Our study found high ratings for resident professionalism and interpersonal skills. However, different members of the health care team rated residents differently, and ratings are not correlated. Our results provide evidence for the potential value of 360-degree evaluations.