摘要
目的通过临床客观结构化考核(objective structured clinical examination,OSCE)对南京医科大学第二附属医院招录“3+2”助理全科医生规范化培训学员进行分阶段的临床能力考核及评估,在学员与临床带教老师层面分析OSCE的应用情况,为进一步促进助理全科医生临床能力提供依据。方法2017年1月—2020年6月,采用OSCE(包括辅助检查结果判读、病史询问、体格检查、病例分析、SOAP病历书写、基本技能操作、医患沟通7个考站),对“3+2”助理全科医生规范化培训学员进行分阶段临床能力评估,根据学员技能考核结果及自我评价、考官评价进行强化训练。其中2018届学员接受了OSCE培训,作为试验组,2017年学员接受了常规住培培训,作为对照组。结果试验组与对照组考核通过率,差异无统计学意义(P>0.05),但考核评分逐渐升高,且第四次考核评分高于对照组,差异有统计学意义(P<0.05)。培训后,两组核心能力评分均提高,但试验组评估干预能力、评判性思维能力、教学能力、管理能力评分更高于对照组,差异有统计学意义(P<0.05)。试验组各项自我评分结果与考官评分结果均呈现逐渐上涨的趋势,差异有统计学意义(P<0.05)。试验组每次自我评分与考官评分均呈正相关。结论OSCE对“3+2”助理全科医生规范化培训学员的临床实践能力与核心能力有着明显的提升效果,完善OSCE考核体系和培训方法,不断推进临床实践教学改革和探索过程性评价对于促进高素质、应用型医学人才培养有着重要的意义。
Objective To evaluate the clinical ability of the"3+2"assistant general practitioners recruited by the Second Affiliated Hospital of Nanjing Medical University through the clinical objective structured examination(OSCE),analyze the application of OSCE at the level of students and clinical teachers,and provide basis for further promoting the clinical ability of assistant general practitioners.Methods From January 2017 to June 2020,the"3+2"assistant general practitioners’standardized training trainees were evaluated in stages by using OSCE(including 7 examination stations including interpretation of auxiliary examination results,medical history inquiry,physical examination,case analysis,soap medical record writing,basic skill operation and doctor-patient communication),and the intensive training was conducted according to the skills assessment results,self-evaluation and examiner evaluation.Among them,the 2018 students received the OSCE training as the experimental group,and the 2017 College received the routine training as the control group.Results There was no significant difference in the passing rate between the test group and the control group(P>0.05),but the assessment score gradually increased,and the fourth assessment score was higher than that of the control group(P<0.05).After the training,the core competence scores of the two groups were improved,but the scores of the evaluation and intervention ability,critical thinking ability,teaching ability and management ability of the experimental group were higher than those of the control group(P<0.05).The results of self-evaluation and examiner’s evaluation in the test group showed a gradual upward trend,with a statistically significant difference(P<0.05).There was a positive correlation between the self score and the examiner’s score in the test group.Conclusion OSCE can significantly improve the clinical practice ability and core competence of the"3+2"assistant general practitioners.It is of great significance to improve the examination system and train
作者
欧婷
徐莹
赵玲
李健桃
颜红
王迪斌
李云涛
OU Ting;XU Ying;ZHAO Ling;LI Jiantao;YAN Hong;WANG Dibin;LI Yuntao(General Practice Base Office,the Second Affiliated Hospital of Nanjing Medical University,Nanjing Jiangsu 210011;Education Section,the Second Affiliated Hospital of Nanjing Medical University,Nanjing Jiangsu 210011)
出处
《中国继续医学教育》
2022年第16期131-136,共6页
China Continuing Medical Education
基金
南京医科大学2019年度教育研究立项资助课题(2019LX046)。
关键词
临床客观结构化考核
助理全科医生
“3+2”模式
临床实践能力
住院医师规范化培训
临床带教
clinical objective structured assessment
assistant general practitioner
"3+2"model
clinical practice ability
resident standardized training
clinical teaching
