Os diferentes olhares na avaliação de alunos em estágio clínico supervisionado / The different perspectives in the assessment of learners during supervised clinical clerkship

RESUMO

OBJETIVO: Comparar notas do Conceito Global Itemizado (CGI) e da Avaliação Estruturada (AE), atribuídas por três especialidades - Ginecologia e Obstetrícia (GO), Clínica Médica (CM) e Pediatria (Ped) - a alunos em final de estágio clínico nas unidades básicas de saúde. MÉTODOS: Cento e seis alunos do 4º ano médico foram avaliados por um docente de cada especialidade, utilizando CGI contendo seis domínios de habilidades técnicas (CGIt) e sete domínios humanísticos (CGIh), em escala 0-10, e pela AE resultante de observação de atendimento. Para análise estatística, utilizaram-se coeficientes de Cronbach, testes de Friedman e pareados de Wilcoxon, coeficientes de correlação de Spearman e Pearson e distâncias Euclidianas (p< 0,05). RESULTADOS: Houve alta consistência interna do CGI nas especialidades (>0,92). As distribuições das notas concentraram-se no extremo superior da escala. As notas de Ped foram significativamente inferiores às de GO e CM (diferenças de medianas entre 0,50 e 0,67), com correlações baixas entre elas (-0,02

ABSTRACT

OBJECTIVE: To compare medical students' global itemized ratings (GIR) and real-case structured clinical assessment (RC-SCA), generated by faculty members from three different specialties (Gynecology-O&G, Internal Medicine-IM, Pediatrics-Ped). METHOD: 106 Y4 learners were assessed by one faculty member from each specialty, who filled in GIR, consisting of 6 technicaldomains (mean score GIRt) and 7 humanistic domains (mean score GIRh), on a 0-10 scale, and resultant RC-SCA, from direct attendance observation. Statistical analyses used Cronbach coefficient, Friedman and Wilcoxon paired tests, Pearson and Spearman correlation coefficients, Euclidean distances. Significance level=5 percent. RESULTS: High internal consistency was observed in the three GIR (> 0.92). Ratings were negatively skewed. Ped scores were significantly lower than O&G and IM (median differences between 0.50 and 0.67), with low correlations between them (-0.02

Subject(s)

Humans; Clinical Clerkship; Educational Measurement/statistics & numerical data; Cultural Characteristics; Epidemiologic Methods; Educational Measurement/methods; Gynecology/education; Internal Medicine/education; Observer Variation; Pediatrics/education

Avaliação educacional; Clinical clerkship; Educational measurement; Especialidades médicas; Estágio clínico; Specialties medical

ABSTRACT

OBJECTIVE: To compare medical students' global itemized ratings (GIR) and real-case structured clinical assessment (RC-SCA), generated by faculty members from three different specialties (Gynecology-O&G, Internal Medicine-IM, Pediatrics-Ped). METHOD: 106 Y4 learners were assessed by one faculty member from each specialty, who filled in GIR, consisting of 6 technicaldomains (mean score GIRt) and 7 humanistic domains (mean score GIRh), on a 0-10 scale, and resultant RC-SCA, from direct attendance observation. Statistical analyses used Cronbach coefficient, Friedman and Wilcoxon paired tests, Pearson and Spearman correlation coefficients, Euclidean distances. Significance level=5 percent. RESULTS: High internal consistency was observed in the three GIR (> 0.92). Ratings were negatively skewed. Ped scores were significantly lower than O&G and IM (median differences between 0.50 and 0.67), with low correlations between them (-0.02