| Opening the black box of clinical skills assessment via observation: a conceptual model. | |
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MedLine Citation:
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PMID: 21916943 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: This study was intended to develop a conceptual framework of the factors impacting on faculty members' judgements and ratings of resident doctors (residents) after direct observation with patients. METHODS: In 2009, 44 general internal medicine faculty members responsible for out-patient resident teaching in 16 internal medicine residency programmes in a large urban area in the eastern USA watched four videotaped scenarios and two live scenarios of standardised residents engaged in clinical encounters with standardised patients. After each, faculty members rated the resident using a mini-clinical evaluation exercise and were individually interviewed using a semi-structured interview. Interviews were videotaped, transcribed and analysed using grounded theory methods. RESULTS: Four primary themes that provide insights into the variability of faculty assessments of residents' performance were identified: (i) the frames of reference used by faculty members when translating observations into judgements and ratings are variable; (ii) high levels of inference are used during the direct observation process; (iii) the methods by which judgements are synthesised into numerical ratings are variable, and (iv) factors external to resident performance influence ratings. From these themes, a conceptual model was developed to describe the process of observation, interpretation, synthesis and rating. CONCLUSIONS: It is likely that multiple factors account for the variability in faculty ratings of residents. Understanding these factors informs potential new approaches to faculty development to improve the accuracy, reliability and utility of clinical skills assessment. |
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Authors:
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Jennifer R Kogan; Lisa Conforti; Elizabeth Bernabeo; William Iobst; Eric Holmboe |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Medical education Volume: 45 ISSN: 1365-2923 ISO Abbreviation: Med Educ Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-09-15 Completed Date: 2012-01-04 Revised Date: 2012-02-16 |
Medline Journal Info:
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Nlm Unique ID: 7605655 Medline TA: Med Educ Country: England |
Other Details:
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Languages: eng Pagination: 1048-60 Citation Subset: IM |
Copyright Information:
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© Blackwell Publishing Ltd 2011. |
Affiliation:
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Department of Medicine, University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania 19104, USA. jennifer.kogan@uphs.upenn.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Clinical Competence / standards* Education, Medical, Graduate / methods*, standards Educational Measurement / methods*, standards Female Humans Internship and Residency Male Middle Aged Models, Theoretical Observation Physician-Patient Relations* Questionnaires Videotape Recording |
| Comments/Corrections | |
Comment In:
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Med Educ. 2011 Oct;45(10):970-2
[PMID:
21916937
]
Med Educ. 2012 Feb;46(2):140-2 [PMID: 22239327 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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