Development of a Peer Review System Using Patient Records for Outcome Evaluation of Medical Education: Reliability Analysis

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Author(s)

    • Kameoka Junichi
    • Office of Medical Education, Tohoku University Graduate School of Medicine
    • Okubo Tomoya
    • Research Division, The National Center for University Entrance Examinations
    • Koguma Emi
    • Office of Medical Education, Tohoku University Graduate School of Medicine
    • Takahashi Fumie
    • Office of Medical Education, Tohoku University Graduate School of Medicine
    • Ishii Seiichi
    • Office of Medical Education, Tohoku University Graduate School of Medicine

Abstract

In addition to input evaluation (education delivered at school) and output evaluation (students' capability at graduation), the methods for outcome evaluation (performance after graduation) of medical education need to be established. One approach is a review of medical records, which, however, has been met with difficulties because of poor inter-rater reliability. Here, we attempted to develop a peer review system of medical records with high inter-rater reliability. We randomly selected 112 patients (and finally selected 110 after removing two ineligible patients) who visited (and were hospitalized in) one of the four general hospitals in the Tohoku region of Japan between 2008 and 2012. Four reviewers, who were well-trained general internists from outside the Tohoku region, visited the hospitals independently and evaluated outpatient medical records based on an evaluation sheet that consisted of 14 items (3-point scale) for record keeping and 15 items (5-point scale) for quality of care. The mean total score was 84.1 ± 7.7. Cronbach's alpha for these items was 0.798. Single measure and average measure intraclass correlations for the reviewers were 0.733 (95% confidence interval: 0.720-0.745) and 0.917 (95% confidence interval: 0.912-0.921), respectively. An exploratory factor analysis revealed six factors: history taking, physical examination, clinical reasoning, management and outcome, rhetoric, and patient relationship. In conclusion, we have developed a peer review system of medical records with high inter-rater reliability, which may enable us, with further validity analysis, to measure quality of patient care as an outcome evaluation of medical education in the future.

Journal

  • The Tohoku Journal of Experimental Medicine

    The Tohoku Journal of Experimental Medicine 233(3), 189-195, 2014

    Tohoku University Medical Press

Codes

  • NII Article ID (NAID)
    130004460139
  • Text Lang
    ENG
  • ISSN
    0040-8727
  • Data Source
    J-STAGE 
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