Selecting and Simplifying: Rater Performance and Behavior When Considering Multiple Competencies

Teaching and Learning in Medicine
Walter TavaresKevin W Eva

Abstract

Assessment of clinical competence is a complex cognitive task with many mental demands often imposed on raters unintentionally. We were interested in whether this burden might contribute to well-described limitations in assessment judgments. In this study we examine the effect on indicators of rating quality of asking raters to (a) consider multiple competencies and (b) attend to multiple issues. In addition, we explored the cognitive strategies raters engage when asked to consider multiple competencies simultaneously. We hypothesized that indications of rating quality (e.g., interrater reliability) would decline as the number of dimensions raters are expected to consider increases. Experienced faculty examiners rated prerecorded clinical performances within a 2 (number of dimensions) × 2 (presence of distracting task) × 3 (number of videos) factorial design. Half of the participants were asked to rate 7 dimensions of performance (7D), and half were asked to rate only 2 (2D). The second factor involved the requirement (or lack thereof) to rate the performance of actors participating in the simulation. We calculated the interrater reliability of the scores assigned and counted the number of relevant behaviors participants identi...Continue Reading

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Citations

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