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首页> 外文期刊>BMC Medical Education >Improving handover competency in preclinical medical and health professions students: establishing the reliability and construct validity of an assessment instrument
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Improving handover competency in preclinical medical and health professions students: establishing the reliability and construct validity of an assessment instrument

机译：在临床前医疗和健康专业学生中提高切换能力：建立评估仪器的可靠性和构建有效性

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As part of the worldwide call to enhance the safety of patient handovers of care, the Association of American Medical Colleges (AAMC) requires that all graduating students “give or receive a patient handover to transition care responsibly” as one of its Core Entrustable Professional Activities (EPAs) for Entering Residency. Students therefore require educational activities that build the necessary teamwork skills to perform structured handovers. To date, a reliable instrument designed to assess teamwork competencies, like structured communication, throughout their preclinical and clinical years does not exist. Our team developed an assessment instrument that evaluates both the use of structured communication and two additional teamwork competencies necessary to perform safe patient handovers. This instrument was utilized to assess 192 handovers that were recorded from a sample of 229 preclinical medical students and 25 health professions students who participated in a virtual course on safe patient handovers. Five raters were trained on utilization of the assessment instrument, and consensus was established. Each handover was reviewed independently by two separate raters. The raters achieved 72.22?% agreement across items in the reviewed handovers. Krippendorff’s alpha coefficient to assess inter-rater reliability was 0.6245, indicating substantial agreement among the raters. A confirmatory factor analysis (CFA) demonstrated the orthogonal characteristics of items in this instrument with rotated item loadings onto three distinct factors providing preliminary evidence of construct validity. We present an assessment instrument with substantial reliability and preliminary evidence of construct validity designed to evaluate both use of structured handover format as well as two team competencies necessary for safe patient handovers. Our assessment instrument can be used by educators to evaluate learners’ handoff performance as early as their preclinical years and is broadly applicable in the clinical context in which it is utilized. In the journey to optimize safe patient care through improved teamwork during handovers, our instrument achieves a critical step in the process of developing a validated assessment instrument to evaluate learners as they seek to accomplish this goal.
机译：作为全球呼吁加强患者护理患者切换安全的一部分，美国医学院（AAMC）协会要求所有毕业生的学生“给予或接受负责任地关注的患者移交”，作为其核心委托专业活动之一（EPAS）进入居留权。因此，学生需要教育活动，以建立必要的团队合作技能来执行结构化切换。迄今为止，旨在评估团队合作能力的可靠文书，如在其临床前和临床年度整个临床前和临床年内都不存在。我们的团队开发了一个评估文书，评估了结构性通信的使用和执行安全患者切换所需的两种额外的团队合作能力。该仪器用于评估192份从229名突出前医学生和25名卫生专业学生的样本记录，他们参与了安全患者切换的虚拟课程。有五位评估人员采用评估工具的利用培训，并建立了共识。每个切换由两个单独的评估者独立审查。评估者在审查的切换中达到了72.22？％综合协议。 Krippendorff的alpha系数评估帧间可靠性为0.6245，表明评估者之间的大量协议。确认因子分析（CFA）证明了该仪器中的物品的正交特性，其具有旋转的物品负荷，其具有提供构建有效性的初步证据的三个不同因素。我们提出了一个具有实质性可靠性和初步证据的评估文书，构建有效性旨在评估结构化切换格式的使用以及安全患者切换所需的两支团队能力。我们的评估工具可以通过教育工作者使用，以评估学习者的切换性能，因为它们的临床前几年并广泛适用于利用它的临床环境。通过改进的团队合作在切换过程中优化安全患者护理的旅程中，我们的仪器在开发经过验证的评估工具的过程中实现了一个关键步骤，以评估学习者，因为他们寻求实现这一目标。

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