Evaluation of resident communication skills and professionalism: A matter of perspective?
Evaluation of resident communication skills and professionalism: A matter of perspective?
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DOI：
10.1542/peds.2005-3214
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发表时间：
2006-10-01
期刊：
影响因子：
8
通讯作者：
Britto, Maria T.
中科院分区：
文献类型：
--
作者：
Brinkman, William B.;Geraghty, Sheela R.;Britto, Maria T.
目标。仅仅依靠主治医生评分的评估程序可能无法识别出表现出不良沟通技巧或不专业行为的住院医生。纳入非医师评估者应该更全面地了解住院医师的能力。没有发表的报告检查了儿科环境中不同来源的住院医师评估之间的关系。本研究的目的是确定家长和护士对住院医师特定行为的评分是否与主治医师的评分有显著差异。36名儿科住院医师在第一年的培训中接受了家长、护士和主治医生的评估。为了进行分析，计算了每个居民对每个项目的最高响应类别的响应百分比。采用符号秩检验比较主治医师评分与家长、护士评分的差异。家长和主治医生的评分在大多数项目上是相似的，但主治医生指出，他们经常无法观察到感兴趣的行为。在尊重员工（69%对97%）、接受建议（56%对82%）、团队合作（63%对88%）、敏感和同情（62%对85%）、尊重保密（73%对97%）、表现出诚信（75%对92%）和表现出责任（67%对83%）等方面，护士对住院医生的评价低于主治医生。在预测出院后需求（46%比25%）和有效规划护理（52%比33%）方面，护士的回答高于主治医生。扩大住院医生的评估程序，使其包括家长和护士，确实可以加强住院医生沟通技巧和专业精神方面的信息收集，并可能有助于针对具体行为进行改进。需要进一步的研究来确定接受父母和护士评估的反馈是否会对住院医师的能力产生积极的影响。
OBJECTIVE. Evaluation procedures that rely solely on attending physician ratings may not identify residents who display poor communication skills or unprofessional behavior. Inclusion of non-physician evaluators should capture a more complete account of resident competency. No published reports have examined the relationship between resident evaluations obtained from different sources in pediatric settings. The objective of this study was to determine whether parent and nurse ratings of specific resident behaviors significantly differ from those of attending physicians.METHODS. Thirty-six pediatric residents were evaluated by parents, nurses, and attending physicians during their first year of training. For analysis, the percentage of responses in the highest response category was calculated for each resident on each item. Differences between attending physician ratings and those of parents and nurses were compared using the signed rank test.RESULTS. Parent and attending physician ratings were similar on most items, but attending physicians indicated that they frequently were unable to observe the behaviors of interest. Nurses rated residents lower than did attending physicians on items that related to respecting staff (69% vs 97%), accepting suggestions (56% vs 82%), teamwork (63% vs 88%), being sensitive and empathetic (62% vs 85%), respecting confidentiality (73% vs 97%), demonstrating integrity (75% vs 92%), and demonstrating accountability (67% vs 83%). Nurse responses were higher than attending physicians on anticipating postdischarge needs (46% vs 25%) and effectively planning care (52% vs 33%).CONCLUSIONS. Expanding resident evaluation procedures to include parents and nurses does enhance information that is gathered on resident communication skills and professionalism and may help to target specific behaviors for improvement. Additional research is needed to determine whether receiving feedback on parent and nurse evaluations will have a positive impact on resident competency.