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首页> 外文期刊>BMC Medical Education >“On the same page”? The effect of GP examiner feedback on differences in rating severity in clinical assessments: a pre/post intervention study
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“On the same page”? The effect of GP examiner feedback on differences in rating severity in clinical assessments: a pre/post intervention study

机译：“在同一页上”？ GP审查员反馈对临床评估中评分严重性差异的影响：干预前/后研究

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Background Robust and defensible clinical assessments attempt to minimise differences in student grades which are due to differences in examiner severity (stringency and leniency). Unfortunately there is little evidence to date that examiner training and feedback interventions are effective; “physician raters” have indeed been deemed “impervious to feedback”. Our aim was to investigate the effectiveness of a general practitioner examiner feedback intervention, and explore examiner attitudes to this. Methods Sixteen examiners were provided with a written summary of all examiner ratings in medical student clinical case examinations over the preceding 18?months, enabling them to identify their own rating data and compare it with other examiners. Examiner ratings and examiner severity self-estimates were analysed pre and post intervention, using non-parametric bootstrapping, multivariable linear regression, intra-class correlation and Spearman’s correlation analyses. Examiners completed a survey exploring their perceptions of the usefulness and acceptability of the intervention, including what (if anything) examiners planned to do differently as a result of the feedback. Results Examiner severity self-estimates were relatively poorly correlated with measured severity on the two clinical case examination types pre-intervention (0.29 and 0.67) and were less accurate post-intervention. No significant effect of the intervention was identified, when differences in case difficulty were controlled for, although there were fewer outlier examiners post-intervention. Drift in examiner severity over time prior to the intervention was observed. Participants rated the intervention as interesting and useful, and survey comments indicated that fairness, reassurance, and understanding examiner colleagues are important to examiners. Conclusions Despite our participants being receptive to our feedback and wanting to be “on the same page”, we did not demonstrate effective use of the feedback to change their rating behaviours. Calibration of severity appears to be difficult for examiners, and further research into better ways of providing more effective feedback is indicated.
机译：背景技术可靠且有根据的临床评估试图将由于考官严重程度（严格度和宽大度）的差异而导致的学生成绩差异最小化。不幸的是，迄今为止，几乎没有证据表明考官的培训和反馈干预是有效的。实际上，“医师评估者”被认为是“无法反馈的”。我们的目的是调查全科医生审查员反馈干预的有效性，并探讨审查员对此的态度。方法为16名检查员提供了在过去18个月内医学生临床案例检查中所有检查员等级的书面摘要，使他们能够识别自己的等级数据并将其与其他检查员进行比较。使用非参数自举，多元线性回归，组内相关和Spearman相关分析，分析了干预前后的检查者评分和检查者严重性自我估计。审查员完成了一项调查，探讨了他们对干预的有用性和可接受性的看法，包括审查员计划由于反馈而打算采取的不同措施（如有）。结果在两种临床病例检查类型（干预前，分别为0.29和0.67）上，检查者的严重程度自我估计与测得的严重程度相关性较差，干预后的准确性较差。当控制病例难度的差异时，尽管干预后的异常检查者较少，但没有发现干预的显着效果。观察到干预前检查者的严重性随时间推移而发生漂移。参加者认为干预是有趣且有用的，调查评论表明，公正，放心和理解考官同事对考官很重要。结论尽管我们的参与者接受了我们的反馈并希望“在同一页面上”，但我们并未证明有效地利用了反馈来改变他们的评分行为。严重程度的校准似乎对检查者来说很困难，并且需要对提供更好有效反馈的更好方法进行进一步研究。

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