Chinese Medical Sciences Journal ›› 2021, Vol. 36 ›› Issue (2): 79-84.doi: 10.24920/003741

• 论著 •    下一篇

中文版诊疗关系共情量表(CARE)用于麻醉科住院医师共情能力的评估:一项标准化病人项目的初步研究

龚亚红,裴丽坚,阮侠,李旭,虞雪融,王锐颖,王维嘉,谭刚,黄宇光()   

  1. 中国医学科学院 北京协和医学院 北京协和医院麻醉科,北京 100730
  • 收稿日期:2020-08-12 出版日期:2021-06-30 发布日期:2021-07-07
  • 通讯作者: 黄宇光 E-mail:garypumch@163.com

Assessing Empathy in Anesthesia Residents with the Chinese Version of the Consultation and Relational Empathy: A Pilot Standardized Patient Program

Yahong Gong,Lijian Pei,Xia Ruan,Xu Li,Xuerong Yu,Ruiying Wang,Weijia Wang,Gang Tan,Yuguang Huang()   

  1. Department of Anesthesiology, Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  • Received:2020-08-12 Published:2021-06-30 Online:2021-07-07
  • Contact: Yuguang Huang E-mail:garypumch@163.com

摘要:

目的 验证中文版诊疗关系共情量表(Consultation and Relational Empathy,CARE)在标准化病人模拟门诊中使用的可靠性。同时探索性地评估视频评分方式和现场评分方式之间的一致性,以及临床考官评分和标准化病人(physician-standardized patient,SP)评分之间的一致性。
方法将CARE量表的内容翻译成中文。纳入48名麻醉住院医师,在标准化病人模拟门诊中进行术前访视。每位住院医师的表现由现场考官、视频考官及SP评分员进行评分。分析不同类别评分员之间的一致性。
结果中文版CARE量表具有较高的信度(Cronbachα值为0.95)和良好的组内相关性(现场考官评分的组内相关系数为0.888,P<0.001)。尽管组内相关性良好,但视频考官的评分显著高于现场考官的评分(39.6±7.1比24.0±10,P<0.001)。Wilcoxon符号秩检验表明,基于视频评分的住院医师考核通过率显著高于现场评分的通过率(45/48比22/48,P<0.001)。SP评分与现场考官评分之间具有中度一致性(系数=0.568,P<0.001),现场考官评分和SP评分的考核通过率之间没有显著性差异(22/48比28/48,P=0.12)。
结论中文版CARE量表能客观、准确评估麻醉术前访视中住院医师的共情能力。现场评分和视频评分之间存在一定的差异,而SP可能能够替代临床考官对住院医师的临床沟通能力进行恰当的评估。

关键词: 共情, 标准化病人模拟门诊, 评估, 评分方式

Abstract:

Objectives To validate the reliability of the Chinese version of the Consultation and Relational Empathy (CARE) in physician-standardized patient (SP) encounter. We also tried to examine the agreement between video-based ratings and in-room ratings, as well as the agreement between the faculty ratings and SP ratings.
Methods The CARE was translated into Chinese. Forty-eight anesthesia residents were recruited to make preoperative interview in SP-counter. Performance of each resident was graded by in-room raters, video raters and SP raters. Consistency between different raters was examined.
Results The Chinese-CARE measure demonstrated high scale reliability with a Cronbach’s alpha value of 0.95 and high consistency in the in-room ratings in intraclass correlation (coefficient=0.888,P<0.001). Despite a good consistency in intraclass correlation, video ratings were significantly higher than in-room ratings (39.6±7.1vs. 24.0±10.0,P<0.001), and Wilcoxon signed-rank test indicated that the pass/fail rate was significantly higher based on video ratings than based on in-room ratings (45/48vs. 22/48, P<0.001). SP ratings had a moderate consistency with in-room faculty ratings (coefficient=0.568,P<0.001), and there was no significant difference between the pass/fail rates based on the in-room ratings and SP ratings (22/48vs. 28/48, P=0.12).
Conclusions The Chinese-CARE measure is reliable in the assessment of empathy during preoperative anesthesia interview. In-room and video ratings are not equivalent, while SP may provide a feasible alternative for the faculty rater in the assessment of communication skills with an appropriate measure.

Key words: empathy, standardized patient encounter, assessment, rating modality

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