「心理衡鑑初次晤談」客觀結構式臨床測驗之初探研究

Development and Initial Validation of the Intake Objective Structured Clinical Examination

在專業能力風潮影響下，心理學家反思心理師教育訓練模式、強調心理專業能力評量的重要性。在 評量上，仍以紙筆測驗與自陳量表為主，較少採實作評量，故本研究擬採用常用的臨床專業能力評 量模式「客觀結構式臨床能力測驗」（Objective Structured Clinical Examination， OSCE），發展衡鑑目 的為初次晤談之「心理衡鑑初次晤談OSCE」（簡稱「初次晤談OSCE」），評估碩士生的衡鑑專業能 力。初次晤談OSCE 包含一個標準化病人測驗站（簡稱SP 站）與一個紙筆站（分成選擇題與簡答題 分測驗）。本研究招募27 位臨床心理碩士生參與研究。研究結果顯示SP 站各分量表與整體量表的 係數皆大於 .8，代表SP 站具良好的內部一致性信度。兩評分者在紙筆站簡答題的評分結果也呈現高 度正相關（r = .75）。在效度方面，研究結果顯示SP 站病史詢問與紙筆站簡答題間，呈現中度正相 關（r = .44），顯示初次晤談OSCE 具良好的聚斂效度。同樣的，「紙筆站選擇題」與SP 站各面向間 呈現低度正相關，也反映初次晤談OSCE 具有良好的區辨效度。以新發展測驗而言，研究結果顯示 初次晤談OSCE 具有一定的信效度。未來，有待更多研究的投入，以提供更完整的驗證與論述。

Influenced by the competency-based movement， psychologists have begun to reconsider what has been missing in the education and evaluation of psychologists， and advocate the importance of competency- based evaluation in professional psychology. In the last four decades， Objective Structured Clinical Examination (OSCE) has been widely adopted in health-related disciplines to measure clinician’s knowledge， skills and attitudes. The purpose of this study was to develop and validate the intake OSCE， a competency-based evaluation for measuring master students’ competencies in psychological assessment when conducting an intake interview. The intake OSCE included a standardized patient test (SP test)， a follow-up short answer test (S test)， and a multiple-choice test (M test). In this study， 27 graduate students in training were recruited to examine the psychometric properties of this test. Results of this study indicated that the Cronbach’s alpha values of the total and subscale scores of the SP test were all above .80; and the inter-rater reliability of the S test was .75. The moderate positive correlation between the history taking subscale scores of the SP test and the S test total scores suggested the convergent validity of the intake OSCE. The weak positive association between the M test total scores and the SP subscale scores also indicated the divergent validity of this test. As a newly developed test， intake OSCE demonstrates good reliability and validity. Since the present study only provided initial validation of this test， more research needs to be done to provide further psychometric evidence for the intake OSCE.