Validation of a checklist to assess ward round performance in internal medicine

Nørgaard, Kirsten; Ringsted, Charlotte; Dolmans, Diana

doi:10.1111/j.1365-2929.2004.01840.x

Cited by 53 publications

(59 citation statements)

References 20 publications

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“…41,42,45,47,61,63,[95][96][97] and unnamed tools described by Woolliscroft et al (unspecified discipline), 68 Brennan and Norman 73 (obstetrics), Beckman et al 92 (internal medicine), and Nørgaard et al 80 (internal medicine). Only 3 had evidence of learning.…”

Section: Tools With Multiple Elements Of Validity Evidencementioning

confidence: 97%

Tools for Direct Observation and Assessment of Clinical Skills of Medical Trainees

Kogan¹,

Holmboe²,

Hauer³

2009

JAMA

502

374

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Context Direct observation of medical trainees with actual patients is important for performance-based clinical skills assessment. Multiple tools for direct observation are available, but their characteristics and outcomes have not been compared systematically.Objectives To identify observation tools used to assess medical trainees' clinical skills with actual patients and to summarize the evidence of their validity and outcomes.Data Sources Electronic literature search of PubMed, ERIC, CINAHL, and Web of Science for English-language articles published between 1965 and March 2009 and review of references from article bibliographies. Study SelectionIncluded studies described a tool designed for direct observation of medical trainees' clinical skills with actual patients by educational supervisors. Tools used only in simulated settings or assessing surgical/procedural skills were excluded. Of 10 672 citations, 199 articles were reviewed and 85 met inclusion criteria. Data ExtractionTwo authors independently abstracted studies using a modified Best Evidence Medical Education coding form to inform judgment of key psychometric characteristics. Differences were reconciled by consensus.Results A total of 55 tools were identified. Twenty-one tools were studied with students and 32 with residents or fellows. Two were used across the educational continuum. Most (n=32) were developed for formative assessment. Rater training was described for 26 tools. Only 11 tools had validity evidence based on internal structure and relationship to other variables. Trainee or observer attitudes about the tool were the most commonly measured outcomes. Self-assessed changes in trainee knowledge, skills, or attitudes (n=9) or objectively measured change in knowledge or skills (n = 5) were infrequently reported. The strongest validity evidence has been established for the Mini Clinical Evaluation Exercise (Mini-CEX). ConclusionAlthough many tools are available for the direct observation of clinical skills, validity evidence and description of educational outcomes are scarce.

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Section: Tools With Multiple Elements Of Validity Evidencementioning

confidence: 97%

Tools for Direct Observation and Assessment of Clinical Skills of Medical Trainees

Kogan¹,

Holmboe²,

Hauer³

2009

JAMA

502

374

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“…Even less is known about how to optimize learning of the other non-medical expert roles. Recently, Norgaard et al (2004) designed a checklist for ward rounds to be used as a learning and assessment tool. The tool, which showed good validity, incorporated issues of medical expertise, communication, collaboration and management/leadership.…”

Section: Discussionmentioning

confidence: 99%

A pilot survey of junior doctors’ confidence in tasks related to broad aspects of competence

2005

Self Cite

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Medical authorities and society are recommending that postgraduate medical education prepare physicians for broad aspects of competence. The most effective ways to prepare physicians for these are not known. The aim of this pilot study was to survey junior doctors' growth in confidence in different physician roles. A total of 165 junior doctors in internal medicine completed a self-administered survey of confidence levels in physician roles. Confidence levels between training levels were compared. Confidence in the roles of medical expert, communicator and collaborator increased between PRHOs and SHOs. Confidence levels increased in all roles between PRHOs and SpRs, but confidence between SHOs and SpRs increased only in the roles of collaborator and scholar. Confidence in the role of professional was low and did not increase significantly between training levels. The SHO year was rated as only moderately useful in facilitating learning of the tasks. These results suggest that growth of confidence in the physician roles proceeds at different rates during postgraduate training. Additional research is needed to identify effective ways for junior doctors to learn broad aspects of competence. Longitudinal tracking will be important to evaluate the effect of educational interventions on patient care.

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“…O uso de um instrumento estruturado, tipo checklist, para avaliação durante a observação de uma consulta auxilia o professor a focar sua atenção em habilidades específicas, aumentando a acurácia na detecção de falhas. Além de servirem como instrumento de avaliação, essas listas servem como ferramenta de aprendizagem, oferecendo elementos objetivos para dar feedback aos alunos, podendo ajudá-los a reforçar seus pontos fortes e a corrigir suas deficiências 10 .…”

Section: Introductionunclassified

“…Tais problemas podem ser minimizados se os docentes estiverem bem preparados como clínicos e como avaliadores, disponíveis, com tempo suficiente para a realização da observação e se o instrumento usado for válido e confiável 10,16 .…”

Section: Introductionunclassified

Avaliando competência clínica: o método de avaliação estruturada observacional

Amaral

Domingues

Bicudo-Zeferino

2007

Rev. bras. educ. med.

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Apesar dos avanços tecnológicos, a história médica, o exame físico e a relação médico-paciente continuam as mais importantes ferramentas diagnósticas e terapêuticas. No entanto, deficiências em habilidades clínicas entre alunos têm sido relatadas. Competência clínica deve ser considerada não apenas a demonstração de comportamentos isolados, mas, sim, a habilidade integrada de pensar, sentir e agir na prática real, um determinado contexto. Por isso, ferramentas de observação direta são bastante úteis para avaliar o que os estudantes fazem ou deixam de fazer durante as consultas. O instrumento de avaliação estruturada parece ser adequado tanto para os avaliadores quanto para os avaliados, uma vez que pode ser usado como um guia de observação e também como uma ferramenta de feedback, ampliando as oportunidades de aprendizagem no cenário clínico. Para que esse instrumento seja aplicado de forma eficaz, justa e confiável, os avaliadores precisam ser adequadamente preparados. A B S T R A C TDespite the technological advances, medical histor y, physical examination and patient-doctor relationship continue being the most important diagnostic and therapeutic tools. However, deficiencies in clinical skills among students have been related. Clinical competence is contextdependent; it is more than a demonstration of isolated behaviors, but an integrative ability to think, feel and act in real practice. Tools for direct obser vation are ver y helpful in evaluating what students are and are not able to do during clinical encounters. So, structured assessment seems to be a valuable instrument both for evaluators and students. It can be used as an observational guide and as a tool for feedback, and enhances the learning opportunities in clinical settings. To effectively apply this method, facult y should be provided with effective training to increase fairness and reliability of the assessment strategy.

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Validation of a checklist to assess ward round performance in internal medicine

Cited by 53 publications

References 20 publications

Tools for Direct Observation and Assessment of Clinical Skills of Medical Trainees

Tools for Direct Observation and Assessment of Clinical Skills of Medical Trainees

A pilot survey of junior doctors’ confidence in tasks related to broad aspects of competence

Avaliando competência clínica: o método de avaliação estruturada observacional

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