PubMed · 15369905
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S McAleer, E A Hesketh, NHS Education for Scotland. 2003. Developing the teaching instinct. 10: Assessment.. https://doi.org/10.1080/01421590320001721751
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Our purpose was to assess the effect of reader experience, fatigue, and scan findings on interpretation time for CT colonography. Nine radiologists (experienced in CT colonography); nine radiologists and ten technicians (both groups trained using 50 validated examinations) read 40 cases (50% abnormal) under controlled conditions. Individual interpretation times for each case were recorded, and differences between groups determined. Multi-level linear regression was used to investigate effect of scan category (normal or abnormal) and observer fatigue on interpretation times. Experienced radiologists (mean time 10.9 min, SD 5.2) reported significantly faster than less experienced radiologists and technicians; odds ratios of reporting times 1.4 (CI 1.1, 1.8) and 1.6 (1.3, 2.0), respectively (P<or=0.001). Experienced and less-experienced radiologists took longer to report abnormal cases; ratio 1.2 (CI 1.1,1.4, P<0.001) and 1.2 (1.0, 1.3, P=0.03), respectively. All groups took 70% as long to report the final five cases as they did with an initial five; ratio 0.7 (CI 0.6 to 0.8), P<0.001. For technicians only, accuracy increased with longer reporting times (P=0.04). Experienced radiologists report faster than do less-experienced observers and proportionally spend less time interpreting normal cases. Technicians who report more slowly are more accurate. All groups reported faster as the study period progressed.
OBJECTIVES: The purpose of this paper is to explore the literature on the portfolio as a tool for the assessment of competence in nurse education. DESIGN: Literature reviews are a valuable source of information; by locating, appraising and synthesising evidence from primary studies they can provide reliable answers to focused questions. They can also help to plan new research by identifying both what is known and not known in a given area. Literature reviews adhere to a scientific methodology which seeks to minimise bias and errors generating inferences based on the synthesis of best available evidence. DATA SOURCES: The literature review was conducted utilising several databases, selected because of their relevance to the subject under review and including CINAHL and MEDLINE as well as a hand search of relevant journals and documents. The search terms included: nurses in education, portfolios and assessment and competence. Articles were included in the review if they focused on portfolios as a method of assessment in nurse education and if they were published after 1993 when portfolios first appeared in the nursing literature. REVIEW METHODS: The review divides the literature into content themes allowing synthesis of the subject looking at consistencies and differences, followed by a summary and key arguments relating to the next theme. RESULTS: Results highlight the importance of clear guidelines for portfolio construction and assessment, the importance of tri-partite support during portfolio development and guidelines for qualitative assessment. Where the portfolio process is well developed there are clear links to competence in practice. CONCLUSIONS: The evidence on portfolios as a means of assessment continues to expand. If educators take on board the lessons learned from previous research and apply it to their assessment process, the difficulties found at present, in defining and measuring competence may be reduced.
OBJECTIVES: A Council of Emergency Medicine Residency Directors task force developed the Standardized Direct Observation Assessment Tool (SDOT), a 26-item checklist assessment tool to evaluate Accreditation Council for Graduate Medical Education resident core competencies by direct observation. Each of the checklist items is assigned to one or more of five core competencies. The objective of this study was to test the interrater measurement properties of the SDOT instrument. METHODS: Two videos of simulated patient-resident-attending physician encounters were produced. Academic emergency medicine faculty members not involved in the development of the form viewed the two encounters and completed the SDOT for each. Faculty demographic data were collected. Data were collected from 82 faculty members at 16 emergency medicine residency programs. The checklist items were used to generate a composite score for each core competency of patient care, medical knowledge, interpersonal and communication skills, professionalism, and systems-based practice. RESULTS: Univariate analysis demonstrated a high degree of agreement between evaluators in evaluating residents for both videos. Multivariate analysis found no differences in rating by faculty when examined by experience, academic title, site, or previous use of the SDOT. CONCLUSIONS: Faculty from 16 emergency medicine residency programs had a high interrater agreement when using the SDOT to evaluate resident core competency performance. This study did not test the validity of the tool. This data analysis is mainly descriptive, and scripted video scenarios may not approximate direct observation in the emergency department.