Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
J Gen Intern Med. 2009 Jan;24(1):74-9. doi: 10.1007/s11606-008-0842-3. Epub 2008 Nov 11.

Effect of rater training on reliability and accuracy of mini-CEX scores: a randomized, controlled trial.

Author information

  • 1Office of Education Research, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA. cook.david33@mayo.edu

Abstract

BACKGROUND:

Mini-CEX scores assess resident competence. Rater training might improve mini-CEX score interrater reliability, but evidence is lacking.

OBJECTIVE:

Evaluate a rater training workshop using interrater reliability and accuracy.

DESIGN:

Randomized trial (immediate versus delayed workshop) and single-group pre/post study (randomized groups combined).

SETTING:

Academic medical center.

PARTICIPANTS:

Fifty-two internal medicine clinic preceptors (31 randomized and 21 additional workshop attendees).

INTERVENTION:

The workshop included rater error training, performance dimension training, behavioral observation training, and frame of reference training using lecture, video, and facilitated discussion. Delayed group received no intervention until after posttest.

MEASUREMENTS:

Mini-CEX ratings at baseline (just before workshop for workshop group), and four weeks later using videotaped resident-patient encounters; mini-CEX ratings of live resident-patient encounters one year preceding and one year following the workshop; rater confidence using mini-CEX.

RESULTS:

Among 31 randomized participants, interrater reliabilities in the delayed group (baseline intraclass correlation coefficient [ICC] 0.43, follow-up 0.53) and workshop group (baseline 0.40, follow-up 0.43) were not significantly different (p = 0.19). Mean ratings were similar at baseline (delayed 4.9 [95% confidence interval 4.6-5.2], workshop 4.8 [4.5-5.1]) and follow-up (delayed 5.4 [5.0-5.7], workshop 5.3 [5.0-5.6]; p = 0.88 for interaction). For the entire cohort, rater confidence (1 = not confident, 6 = very confident) improved from mean (SD) 3.8 (1.4) to 4.4 (1.0), p = 0.018. Interrater reliability for ratings of live encounters (entire cohort) was higher after the workshop (ICC 0.34) than before (ICC 0.18) but the standard error of measurement was similar for both periods.

CONCLUSIONS:

Rater training did not improve interrater reliability or accuracy of mini-CEX scores.

CLINICAL TRIALS REGISTRATION:

clinicaltrials.gov identifier NCT00667940

PMID:
19002533
[PubMed - indexed for MEDLINE]
PMCID:
PMC2607488
Free PMC Article

Images from this publication.See all images (1)Free text

FigureĀ 1
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for Springer Icon for PubMed Central
    Loading ...
    Write to the Help Desk