临床操作技能评估在社区全科师资培训中的效果评价

Short-term training of direct observation procedural skills （DOPS） for community generalpractitioner trainers

目的通过对社区全科师资进行短期临床操作技能评估（DOPS）应用培训，了解在社区带教中开展DOPS的需求与可行性，探索如何推广DOPS在临床教学中的应用。方法2012年9月对36名社区全科师资进行为期一天的集中培训，培训前后采用问卷调查了解DOPS认知情况及培训需求；通过对观察示范操作录像后的评分进行分析，评价培训效果。结果培训前47．2％（17／36）的社区师资曾听说过DOPS、并了解评分表，41．7％（15／36）了解DOPS的实施步骤，仅2．8％（1／36）曾用过DOPS，36名师资均希望了解“如何实施DOPS”。培训后绝大多数师资对DOPS的11项考核标准及实施反馈达到完全理解或基本理解。示范录像的11项标准中，有4项的9分制正确率超过或接近50．0％，有7项的等级评分正确率在50．0％以上；共有6项标准的9分制正确率和等级正确率比较差异存在统计学意义（均P〈0．01）。结论社区师资认同DOPS在操作技能评估方面的优势，有较强的使用意愿，短期集中培训具有一定效果，在此基础上还应进行评分者培训，并在实际应用中加强经验交流与反馈。

Objective To evaluate the efficacy of short-term training of direct observation procedural skills （DOPS） for conmmnity general practitioner （GP） trainers. Methods Thirty six GP trainers participated in one-day workshop of DOPS. The participants were interviewed with questionnaire before and after the training program and the training video was scored. Results 47.2% （ 17/36 ） of GP trainers knew and briefly understood DOPS before the training. 41.7% （15/36） of them had a rough idea of how to use it and only 2. 8% （ 1/36 ） had used it before. All of these trainers wanted to learn how to perform DOPS. The vast majority of GP trainers completely or basically understood the standards for evaluation of 11 items of DOPS after the training. The accuracy rates of 4 items were close to or more than 50. 0% in 9-point scale and 7 items exceeded 50. 0% in 3-rank system. There was significant difference in accuracy rates of 6 items between the two scoring system（ all P 〈 0.01 ）. Conclusions Community GP trainers recognize the advantages of DOPS in assessment of clinical skills and have strong intention of application, The efficacy of short-term workshop is satisfactory, but the evaluators need more training and practice,