应用迷你临床演练评估对新生儿科住院医师规范化培训的实践探索

Mini-clinical evaluation exercise assessment in standardized residency training of neonatology

目的本研究探讨迷你临床演练评估(mini-clinical evaluation exercise,Mini-CEX)在新生儿科住院医师规范化培训(简称住培)中的应用价值。方法研究选取2017年7月至2018年6月轮转至新生儿科的32名住培的医师,分别在入科后3d、出科前3d使用Mini-CEX进行考核,比较入科前后Mini-CEX中七项分值,以及考核医师和住院医师对考核满意度。结果研究结果表明:新生儿科住培的医师在出科时的体格检查、人文关怀、临床判断、沟通技能、整体评价方面分值明显优于入科时(P<0.01),差异有统计学意义;考核医师和住院医师入科时对考核的满意度与出科时相比差异有统计学意义(分别为P<0.05和P<0.01)。结论Mini-CEX是一种具有教学、评估、即时反馈功能的医学教学工具。使用Mini-CEX在入科后、出科前对住培的医师进行考核,有利于发现医师临床技能和科室医学教学的薄弱之处,值得推广。

Objecive To find out about the applicability of mini-clinical evaluation exercise(Mini-CEX)in assessing neonatal residents under standardized training.Methods Thirty-two residents under standardized training in the Department of Neonatology between July 2017 and June 2018 were tested using Mini-CEX three days after the start of residency(T1)and three days before the end of residency(T2)in the Department of Neonatology.All the seven-item scores of Mini-CEX before and after admission,as well as the levels of satisfaction of the examiners and residents with the results of tests were analyzed.Results Their scores of physical examination skills,humanistic qualities professionalism,clinical judgement,counselling skills,and global clinical competence at T2 were much better than at T1(P<0.01),and the difference was statistically significant.There was statistically significant difference in the levels of satisfaction of the examiners and residents with the results of tests between T1 and T2.Conclusion Mini-CEX is an effective medical teaching tool that can be used for teaching,assessment and instant feedback,so it should be widely used in standardized residency training.