医师考核360度评价法的可靠性、有效性及可行性的系统研究

医师考核360度评价法的可靠性、有效性及可行性的系统研
究
张健;吴华章
【期刊名称】《中国继续医学教育》
【年(卷),期】2016(000)003
【摘要】目的：研究医师绩效考核360度评价法的可靠性、普遍性、有效性及可行性。

方法检索EMBASE、MEDLINE及PubMed数据库中经同行评议过的、1975～2013年12月发表的英文文献。

检索标准：使用360度评价法工具考核医师绩效；有关360度评价法可靠性、概化系数和建构效度的报道证据；文献中涉及收集反馈数据过程可行性的信息。

结果（1）入选43篇同行评议研究，其中家庭医学、儿科与内科专业各5篇，外科4篇，妇产科3篇，精神病学3篇，麻醉2篇以及急救医学、实验病理、组织病理、放射学、运动医学和康复专业各1篇。

（2）38篇（91%）研究由医生的医疗同行完成360度评价法调查问卷；32篇（74%）研究由医生的非医生同事完成，23篇（53%）研究由患者和（或）患者家属完成，22篇（51%）研究由自我评价完成。

（3）自我评价项目4～57条，医疗同行评价项目4～60条，同事评价项目4～60条，患者问卷评价项目3～49条。

（4）26篇（62%）报道了360度评价法工具的可靠性，360度评价法工具的α应该≥0.90，医疗同行0.89～0.99，同事0.91～0.96，患者0.93～0.99。

17篇（40%）描述了普遍性系数，医疗同行评价工具的普遍性系数为0.61～0.88，同事评价工具为0.56～0.87，患者评价工具为0.65～0.85。

（5）至少由8名医疗同行、8名同事和25名患者评价才能达到可靠性系数≥0.90，普遍性系数≥0.80的要求。

结论应用360度评价法考核医师绩效具有较高的可靠性、有效性及可行
性。

%ObjectiveTo investigate the reliability, validity, and feasibility of 360-degree evaluation for the assessment of physicians.Methods We searched the EMBASE, MEDLINE and PubMed databases for peer-reviewed, English-language articles published from 1975 to December 2013. Studies inclusion criteria was following: used 360-degree evaluation instruments to assess physician performance; reported psychometric evidence of the 360-degree evaluation instruments in the form of reliability, coefficients, and construct or criterion-related validity; and information regarding the feasibility of the feedback data.Results (1) A total of 43 articles were included, the specialties as following: family medicine(n=5), pediatrics(n=5), internal medicine(n=5), surgery(n=4),obstetrics-gynecology(n=3), psychiatry(n=3), anesthesia(n=2), and emergency medicine(n=1), pathology(n=1), histopathology(n=1), radiology(n=1). (2) A total of
38(91%) studies were completed by the physicians’peers or medical colleagues, and nonphysician coworkers(n=32,74%), patients(n=23,53%), and self-assessments(n=22,51%). (3) The number of items was 4 to 57 items for self-assessment, 4 to 60 items for peers, 3 to 49 items for patient questionnaires. (4) The reliability of the 360-degree evaluation instruments was reported in 26(62%) of the studies. The instruments should have
anα≥0.90, and medical colleague(0.89 to 0.99), coworker (0.91 to 0.96), and patient(0.93 to 0.99). The generalizability coeffcients were derived in 17 studies(40%), and the coefficients for the medical colleague instrument ranged from 0.61 to 0.88, 0.56 to 0.87 for the coworker instrument, and 0.65 to 0.85 for patient instrument. (5) The assessment of physician
performance was based on the completion of the 360-degree evaluation instruments by 8 medical colleagues, 8 coworkers, and 25 patients to achieve α≥0.90 and coeffcients≥0.80, respectively.Co nclusion The 360-degree evaluation as a method to assess physicians has been shown to have high reliability, validity, and feasibility.
【总页数】3页(P1-3)
【作者】张健;吴华章
【作者单位】110002沈阳，中国医科大学口腔医学院;110122沈阳，中国医科大学人文社科学院
【正文语种】中文
【中图分类】R197
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