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Inter-Rater reliability of a professionalism OSCE developed in family medicine training University of Medicine and Pharmacy

Original Research
  • Pham Duong Uyen Binh, Pham Le An, Tran Diep Tuan, Jimmie Leppink,
  • Pages 20-24

A POSCE was developed and administered in 2015 to assess six professional attributes for the Family Medicine (FM) residents, University of Medicine and Pharmacy (UMP), Vietnam. This study aims at exploring inter-rater reliability in FM POSCE developed in this context when analytic rubrics were applied.

Background: Past POSCEs showed raters’ variability on applying the global marking items and holistic rating. Using analytic rubrics, unlike holistic type, will provide more rationale for assigning a certain score might influence raters’ variability. Nonetheless, it is little known to what extent switching to this rubric type might influence the inter-rater reliability of POSCE.  

Methods:  Before the FM professionalism module (pretest) and after this module (posttest), 36 and 42 FM residents took the POSCE respectively. The raters in the pretest included 12 teachers of FM training center. Four faculty members from different faculties were belatedly added to the post-test together with the 12 former raters.  Raters’ training occurred in two different times, the former took place only for the 12 FM raters before the pretest and the latter was before the posttest for the 4 belatedly-recruited. During the POSCE, one pair of raters observed all performances per station. Inter-rater reliability was measured by the differences in total scores between raters per pair using paired t-test and Pearson correlation coefficient.  

Results: In POSCE pretest, no significant difference was found between raters’ scores in most pairs of raters, contrasting with that in the posttest. Most differences were noticed in the pairs of raters, in which one of the raters was the belatedly-recruited. In the pretest, moderate to strong positive correlation between raters’ mean scores were found (r=0.55-0.85), similar range was seen in the post-test (r=0.47-0.87), however, the correlation slightly weakened.   

Discussion and conclusion: The FM POSCE has high inter-rater reliability on the utilization of analytic grading rubrics. An analytic rubric might help minimize the discrepancies among raters. Moreover, training raters might have been an alternative influential factor on the raters’ consensus.

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The First Annual National Vietnam Medical Education Conference “Preparing the 21st Century Physician”

Editorial Letter
  • Tran Diep Tuan,
  • Pages 1-2

Assoc. Prof. Dr. Tran Diep Tuan

President of University of Medicine and Pharmacy at Ho Chi Minh City, Department of Pediatrics - UMP

We are delighted to introduce the Special Issue for the medical education derived from the 1st National Vietnam Medical Education Conference: “Preparing the 21st Century Physician”. The First Annual National Vietnam Medical Education Conference was held on 2-3 December, 2017, by the Vietnam Ministry of Health, University of Medicine and Pharmacy in Ho Chi Minh City, and the Improving Access, Curriculum and Teaching in Medical Education and Emerging Diseases (IMPACT-MED) Alliance, which is supported by United States Agency for International Development (USAID) and implemented by Partnership for Health Advancement Vietnam, a collaboration between Harvard Medical School, the Brigham & Women’s Hospital and the Beth Israel Deaconess Medical Center. It has attracted approximately 300 leaders in the medical education, faculties and students from Vietnam and around the world.

This conference comes at an exciting time in the socio-economic development of Vietnam. The Vietnamese health sector has made enormous strides in the control of communicable diseases, increasing the life expectancy and increasing access to the health care for its population over the past 40 years since the reunification of the country. In July 2017, Vietnam became a middle-income country, and with this new status comes new health challenges, which if not addressed, will impede the continued development of the country.  Non-communicable diseases, a rapidly aging population, emerge threats of pandemics, environmental pollution, and climate change are all at our doorstep. Additionally, an increasingly connected society that demands a high-quality healthcare, the government’s plan for Universal Health Care, and the desire for regional and an international integration all represent the challenges and opportunities that we must tackle. Addressing these challenges and opportunities starts with transforming the health workforce. There is an urgent need to update the country’s system of health education including university curricula and transforming approaches to teaching and learning to train health professionals who can adapt and react to the health challenges and realize the opportunities that are presented.

A comprehensive curriculum reform is difficult.  However, we can build upon the experience of previous, smaller-scale reform projects, and capitalize on the investments and support from the highest level of government to transform our health education system. We have built strong partnerships among the network of universities and colleges in Vietnam to support each other, and we also have support from international partners. Education reform is a necessity for Vietnam. The conversations and discussions that we have at this inaugural conference will pave the way towards the transformation of our health education system. The conference aims to provide a forum for sharing innovations and advances in the medical education, stimulate discussions among medical education leaders, inspire further innovations, and foster a community of medical educators invested in advancing medical education research and quality improvement.

This entire volume is devoted to select the manuscripts, which was generated from the conference. We hope that it will be productive, and you will be inspired, energized and motivated to continue the efforts towards health education reform for your university/college, and for the country of Vietnam.

Graphical abstract

Content validity of a professionalism OSCE developed in family medicine training University of Medicine and Pharmacy at Ho Chi Minh city Vietnam

Original Research
  • Pham Duong Uyen Binh, Pham Le An, Tran Diep Tuan, Jimmie Leppink,
  • Pages 6-11

Background: Assessments of professional behaviors such as professionalism Mini clinical examination (PMEX) and OSCE (POSCE) are playing an important role in driving the practice professionalism in medical training. Simulation-based assessment or POSCE has been used to evaluate several professional attributes. However, few evidence of content validity proving that whether POSCE is really measuring specific professional attributes have been reported in medical education literature.

Methods:  The four-step process of developing FM POSCE was analyzed to highlight the validity evidence according framework of Downing (2003). Group of 5 independent FM experts from Vietnam, Boston University, US and Liege, Belgium evaluated the blueprints, scenarios and item lists on a scale (1-totally disagree to 5-totally agree) regarding to what extent test blueprint, cases and item lists were relevant to the content domains and cultural context. The results of their evaluation were considered as an evidence of content validity. The mean and standard deviation of the scores given by them were calculated using SPSS, 20.0.

Results: Important evidence of content validity were found in the process of developing POSCE. Content experts’ evaluation showed that all professional attributes represented medical professionalism. However, the adequacy of professional attributes to evaluate the broad construct of professionalism was controversial (M=3.75, SD=0.95). Cases are relevant to assess these professional attributes and culture. Only the cases of “Respecting the patient” and “Making altruistic decision” contained some inappropriate marking items (M=3.75, SD=0.95; M=3.00, SD=0.92).  

Discussion and conclusion: FM POSCE developed in Vietnamese context can assess six specific professional attributes. This study suggested a process of developing POSCE that has several features such as using both sources of expertise and medical literature to build up the content of POSCE to improve the content validity.

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Letter from President of UMP

Letter from President
  • Tran Diep Tuan,
  • Pages 1-1
  • 10/12/2017
  • 17
  • 2697
  • Free

Assoc. Prof. Dr. Tran Diep Tuan

President of University of Medicine and Pharmacy at Ho Chi Minh City, Department of Pediatrics - UMP

 

Since our founding in 1947, the University of Medicine and Pharmacy at Ho Chi Minh City (UMP) has consistently worked hard to be a well-established and highly ranked university in Vietnam and the region. We aspire to provide a healthy scientific environment for our students, faculty and researchers. UMP is committed to advance scientific research and innovation, providing our community with the necessary tools in order to achieve these aspirations.

The MedPharmRes journal represents a major step that UMP has undertaken to provide a stage for academics to spread, promote, discuss their ideas and research. MedPharmRes is an open-access, peer-reviewed journal that is dedicated to publishing cutting-edge research that will help and promote change in the practice of medicine. We believe that science should be available to everyone and to prevent any limitations in the publishing process, UMP will sponsor publication associated fees between 2017 and 2018. This will allow academics from all backgrounds to submit for publication in our Journal. MedPharmRes applies high standards towards the peer- review process to ensure strict standards in methodological design and valid results. We emphasize the accuracy of research methodology and high ethical standards.  Our live online, blinded review process will allow both reviewers and authors to discuss the manuscript which will allow fair and accurate review of the submission, ensuring that the journal’s high standards are met.

In this inaugural issue, we would like to thank all the editorial and peer reviewers for their efforts. We hope that academics from around the world will choose to publish their research in this Journal, in order to promote high quality research, contributing to the development and advancement of of medical practice in Vietnam and around the world.

 

Graphical abstract

The Vietnamese Version of the Health-related Quality of Life Measure for Children with Epilepsy (CHEQOL-25): Reliability

Original Research
  • Tri Huu Doan, Tran Diep Tuan, Han Bao Huu Nguyen,
  • Pages 9-14
  • 10/12/2017
  • 76
  • 1142
  • Free

Purpose: This study aimed to translate and culturally adapt the self-report and parent-proxy Health-Related Quality of Life Measure for Children with Epilepsy (CHEQOL-25) into Vietnamese and to evaluate their reliability.

Methods: Both English versions of the self-report and parent-proxy CHEQOL-25 were translated and culturally adapted into Vietnamese by using the Principles of Good Practice for the Translation and Cultural Adaptation Process. The Vietnamese versions were scored by 77 epileptic patients, who aged 8–15 years, and their parents/caregivers at neurology outpatient clinic of Children Hospital No. 2 – Ho Chi Minh City. Reliability of the questionnaires was determined by using Cronbach’s coefficient α and intra-class correlation coefficient (ICC).

Results: Both Vietnamese versions of the self-report and parent-proxy CHEQOL-25 were shown to be consistent with the English ones, easy to understand for Vietnamese children and parents. Thus, no further modification was required. Cronbach’s α coefficient for each subscale of the Vietnamese version of the self-report and parent-proxy CHEQOL-25 was 0.65 to 0.86 and 0.83 to 0.86, respectively. The ICC for each subscale of the self-report and parent-proxy CHEQOL-25 was in the range of 0.61 to 0.86 and 0.77 to 0.98, respectively.

Conclusion: The Vietnamese version of the self-report and parent-proxy CHEQOL-25 were the first questionnaires about quality of life of epileptic children in Vietnam. This Vietnamese version was shown to be reliable to assess the quality of life of children with epilepsy aged 8–15 years.

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