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We will conduct a faculty development workshop with intent to improve interrater reliability and rater accuracy. Outcomes will include interrater reliability, accuracy, and workshop evaluations.
Hypothesis: An intervention for training faculty preceptors on the use of the mini-CEX will improve inter-rater reliability and classification accuracy.
Methods. We will develop a faculty development workshop aimed at improving the inter-rater reliability and accuracy of mini-CEX scores. To evaluate the workshop we will conduct a randomized, controlled trial. Preceptors will be randomly assigned to immediate or delayed workshop. The primary outcome will be inter-rater reliability of mini-CEX scores as preceptors rate videotaped resident-patient encounters before and four weeks after the workshop. We will also evaluate the accuracy of performance classifications. We will also collect mini-CEX ratings of actual resident-patient interactions one year preceding and one year following the workshop, and calculate interrater reliability.
Statistical methods. Inter-rater reliability will be determined using the intraclass correlation coefficient (ICC) and corresponding confidence intervals. ICC will be used to determine chance-corrected agreement (accuracy). Discrimination (differences in mean scores among scripted levels of performance) will also be evaluated as a measure of accuracy.
Scientific basis. Clinical performance assessments constitute a key element of resident education. The effect of rater training on the inter-rater reliability of mini-CEX scores is unknown. This workshop will utilize methods (rater error and field of reference training) shown to be effective in improving rater accuracy in non-medical fields.
Inclusion criteria. All internal medicine residency continuity clinic preceptors are eligible.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Workshop | Experimental | Rater training workshop: rater error training, performance dimension training, behavioral observation training, and frame of reference training using lecture, video, and facilitated discussion |
|
| Delayed workshop | No Intervention | No specific intervention until after follow-up assessment, then receives same workshop. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Rater training workshop | Behavioral | Rater training workshop: rater error training, performance dimension training, behavioral observation training, and frame of reference training using lecture, video, and facilitated discussion |
| Measure | Description | Time Frame |
|---|---|---|
| Interrater reliability (videotaped resident-patient encounters) | April-June 2006 |
| Measure | Description | Time Frame |
|---|---|---|
| Rater accuracy (agreement with scripted levels of performance on videotaped resident-patient encounters): percent agreement, chance-corrected agreement, mean scores | April-June 2006 | |
| Interrater reliability (actual resident-patient encounters) | March 2005 (historical) to June 2007 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| David A Cook, MD, MHPE | Mayo Clinic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mayo Clinic | Rochester | Minnesota | 55905 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19002533 | Derived | Cook DA, Dupras DM, Beckman TJ, Thomas KG, Pankratz VS. Effect of rater training on reliability and accuracy of mini-CEX scores: a randomized, controlled trial. J Gen Intern Med. 2009 Jan;24(1):74-9. doi: 10.1007/s11606-008-0842-3. Epub 2008 Nov 11. |
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