Mini-CEX考核模式在助理全科医生培训中的应用研究

Application of Mini-CEX assessment mode in assistant general practitioner training

目的研究迷你临床演练评估(mini-clinical evaluation exercise,Mini-CEX)在助理全科医生培训出科考核中的应用效果。方法培训基地整体抽取2018级、2019级参加培训的助理全科医生,在各轮转科室出科考核中应用Mini-CEX考核模式。3年内(2018年9月—2020年8月),从助理全科医生接待患者、询问病史到出具诊疗方案,从7个维度对诊疗全过程分26项给予评价。考核老师现场给予助理全科医生问题反馈,双方就满意度互评打分,最后对考核结果进行分析研究。结果3年内共计完成846次有效Mini-CEX考核,助理全科医生Mini-CEX考核平均分均超过4分,总平均分区间为3.81~6.67分,总平均分为5.24分,考官满意度得分(4.85±1.50)分,考生满意度(8.20±0.64)分。不同培训阶段助理全科医生,Mini-CEX考核成绩7个维度单项成绩及总平均分比较,差异有统计学意义(P<0.01);同一培训阶段助理全科医生,年度考核成绩7个维度单项成绩及总平均分间无差异(P>0.05)。结论助理全科医生培训提高了助理全科医生的临床诊疗综合能力,Mini-CEX考核能真实全面反映助理全科医生临床诊疗能力,可以作为培训基地教学质控的方式,有助于提升教学质量。

Objective To study the application effect of Mini-Clinical Evaluation Exercise(Mini-CEX)in the standardized training and department rotation examination of assistant general practitioners.Methods MiniCEX assessment mode was applied to department rotation examination for assistant general practitioners taking part in the training in 2018 and 2019.In 3 years(2018.09-2020.08),Mini-CEX assessments,from the assistant general practitioners recruiting patients,asking medical history to presenting the diagnosis and treatment,evaluated in 26 items from 7 dimensions,and teachers gave the question feedback on the spot.Both sides scored on the degree of satisfaction,which were analyzed and studied.Results A total of 846 valid Mini-CEX examinations were completed in the past three years.The average score of assistant general practitioners’Mini-CEX was more than 4.The total average score ranged from 3.81 to 6.67,and the total average score was 5.24.The satisfaction of the examiner was(4.85±1.50),the satisfaction of the examinee was(8.20±0.64).There was a significant difference between MiniCEX trained assistant doctors at different training stages(P<0.01),but there was no significant difference between the 7-dimension single score and the total average score(P>0.05)at the same training stage.Conclusion The standardized training of assistant general practitioners improves the comprehensive ability of clinical diagnosis and treatment of assistantdoctors,and the Mini-CEX assessment can truly and comprehensively reflect the clinical diagnosis and treatment ability of assistant doctors,which helps to improve the teaching quality in the base.