- 期刊
- OpenAccess
客觀結構式臨床測驗檢核表信效度之建立－以腦中風個案之布朗斯壯動作能力三和四級評量為例
Construction of a Valid and Reliable Checklist for Objective Structured Clinical Examination-an Example of Brunnstrom Motor Recovery Stage III / IV Assessment for Cerebral Vascular Accident
摘要
客觀結構式臨床測驗(Objective Structured Clinical Examination, OSCE)是目前醫學教育用以評估學生臨床技能的重要方法。本研究目的乃以先驅測試的方式，以腦中風(Cerebral Vascular Accident, CVA)個案之布朗斯壯動作能力評量為例，檢驗CVA之OSCE檢核表，期望產生具備信效度的項目。本研究專家效度分析採用項目內容效度指標和量表內容效度指標。主考官間信度分析採用加權卡帕係數、皮爾森相關係數和配對樣本t檢定。並採用Cronbach's α係數進行試題內部一致性檢定。共有5位專家、2位主考官和32位職能治療學系大三學生參與。結果指出，內在一致性分析方面，透過專家效度之建議，刪除生活史和居家環境之後，已獲得良好之內在一致性。考生之表現，除了試題5（生理狀態）之外，皆高於1.00分（滿分2分）。在所有呈現顯著差異之試題中，考官間評分一致性僅達到一般可接受之範圍，而考官評分之間達到中度之正相關。整體而言信效度方面需要再加強改善。本文建議未來可增加考生版檢核表之結構性、具體化溝通項目的檢核標準、和選擇有詳細操作定義的評量考題等。期望透過OSCE的評量，得以提升學生臨床技能與學校端之教學品質，協助學生能夠順利銜接學校、實習與就業之過渡期。
並列摘要
Objective Structured Clinical Examination (OSCE) is a method of testing students' clinical skills in medical education. This preliminary research aimed to construct a checklist for Cerebral Vascular Accident (CVA) OSCE based on the Brunnstrom recovery assessment stages. The reliability and validity of the CVA OSCE checklist were examined. The item-content validity index and content validity index for scales were used for expert validity analysis. The weighted Kappa coefficient, Pearson correlation coefficient, and paired t test were used for reliability analysis. Cronbach's α was used for internal consistency analysis. Five experts, 2 testers, and 32 students were recruited. The results indicated that, after deletion of the items of ＂life style＂ and ＂home environment＂, the internal consistency was good. All of the students exhibited good performance in spite of the item of ＂physical attitude＂. Most of the items generating significant results appeared to have acceptable inter-rater reliability. Based on the findings, it is recommended that structured testing for students be added, that concrete testing guidelines be developed for communication items, and that detailed procedures be developed for select testing topics. It is expected that the gap between clinical practice and school education can be diminished through OSCE.
延伸閱讀
- 蔣世光、譚偉象、潘能靜、張勤金、陳永誠、平烈勇、林知遠（2007）。檢驗魏氏成人智力測驗第三版(WAIS-Ⅲ)的Blyler和四個分測驗組成的簡式版本在住院慢性精神分裂症病患的適用性。臺灣精神醫學，21(1)，26-36。https://doi.org/10.29478/TJP.200703.0004
- 王鼎嘉、吳玉欣、郭乃文、黃茂雄、蘇炯輝（2016）。應用中文簡短式智能評估（MMSE-C）與盧-尼神經心理測驗組篩檢測驗（LNNB-S）於腦中風患者之篩檢比較。台灣復健醫學雜誌，44(1)，19-27。https://doi.org/10.6315/2016.44(1)03
- 陳怡君、王雲充、吳至翔、許家禎（2023）。【論文摘要】物理治療參與跨專業團隊使用腦中風物理治療早期離床訓練功能群組（PSTFG）對於認知動機低落之腦中風患者復健之成效：個案報告。物理治療，48(2)，146-147。https://doi.org/10.6215/FJPT.202306.P27
- Stacey, D., Macartney, G., Carley, M., Harrison, M. B., Triage, T. P. C. O. S., & COSTaRS (2013). Development and Evaluation of Evidence-Informed Clinical Nursing Protocols for Remote Assessment, Triage and Support of Cancer Treatment-Induced Symptoms. Nursing Research and Practice, 2013(), 33-43. https://doi.org/10.1155/2013/171872
- Chou, L. Y. (2011). Quantitative Assessment of the Effects of Ischemic Compression, Prolotherapy, and Strengthening Exercises on Cervicogenic Cephalic Syndrome [doctoral dissertation, National Taiwan Normal University]. Airiti Library. https://www.airitilibrary.com/Article/Detail?DocID=U0021-1610201315251100