ABSTRACT
We investigated causes of interrater disagreements in the observational assessment of clinical training for first-year postgraduate trainees. In 1998 25 first-year postgraduates rotated through the Second Department of Surgery for 3 months, including 1 month in cardiovascular surgery, thoracic surgery, and upper-gastrointestinal surgery. Each trainee cared for several patients at most with a senior resident under the supervision of senior staff members. Nine attending physicians (staff members), 3 doctor-course graduates, and 2 chief residents assessed the trainees at the end of the rotation with special reference to clinical, social, and supervisory abilities. Trainees were given scores of “Good, ” “Fair, ” “Pass, ” or “Fail” for each ability. Interrater disagreements often involved responsibility and activeness, which reflected social abilities, and rapid patient consultations, orderly arrangement of laboratory examinations and procedures, and avoiding ordering of unnecessary laboratory examinations and medications, which reflected supervisory abilities. Assessments of poorly performing trainees often disagreed. Some interrater disagreements were seen among 4 of 14 attending physicians, but disagreements were fewer among the 3 doctor-course graduates and 2 chief residents who were graduates of the college. Both the proper training of assessors and a good relationship between assessors and rotators are necessary to make appropriate evaluations that might affect the career of postgraduates trainees.
ABSTRACT
A self-reporting questionnaire was designed and sent to our Jichi Medical School graduates each year since 1980, in order to investigate clinical competences attained in certain technical items. The responses from graduates of classes 1984 through 1987 were analysed, and the questionnaire was found to be highly reliable and moderately valid. The coefficient variable was 0.942, and the relevant variable was 0.934 using the half-split method. The content was clear, because items in the questionnaire were selected from published official reports. In the construction validity, 4 meaningful groups of items were found by factor-analysis. Yearly analysis using such a questionnaire may clarify some of the problems experienced by trainees and training hospitals, and would encourage the trainees to undergo a process of selfevaluation.
ABSTRACT
A self-reporting questionnaire was designed and sent to our Jichi Medical School graduates each year since 1980, in order to investigate clinical competence. The format was designed based on several major reports concerning postgraduate clinical training in primary medical care. We found that more than 70% of Jichi Medical School graduates trained in the multi-specialty rotation style in general hospitals that were certified by the Ministry of Health and Welfare. Our results also suggested that these graduates obtained a relatively high level of clinical competence in performing physical examinations, basic laboratory testing, clinical procedures, and various treatments.