自我评估法在内科住院医师病史采集技能培训中的应用

Application of Self-assessment Method in Medical History Collection Skills Training of Internal Medicine Residents

目的 评价自我评估法在住院医师病史采集技能训练中的效果.方法 入选参加第一年住院医师规范化培训的住院医师共60名.编制针对心血管系统主要症状的病史采集自我评估表单.在采用标准化病人对病史采集完整性进行基线评估后,60名住院医师被分别随机分入常规培训组30名及自我评估培训组30名.经过30 d的训练期后,再次采用标准化患者进行病史采集完整性考核评分.结果 自我评估组和常规培训组的病史采集完整性水平均较培训前有显著提高,而且自我评估组在培训周期结束后病史采集完整性评分上高于常规培训组,差异具有显著性(95.0±2.7 vs 91.8±3.0,P<0.05).结论 与传统的教学方法相比,采用以项目为脚本的自我评估法进行病史采集完整性的训练能够更加有效地促进问诊技能的提高.

Objective To evaluate the effect of self-assessment method on the skill training of resident medical history collection.Methods A total of 60 residents were enrolled in the first year's standardized residency training program.A self assessment form for the history of cardiovascular symptoms was developed.60 residents were randomly assigned to 30 regular training groups and 30 self-assessment training groups,respectively,after performing a baseline assessment using standardized patients for completeness of medical history.After a 30 d training period,the standardized patients were recollected for histological integrity testing.Results Self assessment group and history collection integrity level of conventional training group were significantly increased than that before training,and self assessment group in the training period after the end of history collection integrity score is higher than that of the conventional training group,the difference was significant(95.0±2.7vs91.8±3.0,P<0.05).Conclusion Compared with the traditional teaching methods,using the project-based self-assessment method to collect the integrity of medical history collection can more effectively improve the skills of medical consultation.