OSCE在临床技能考核中的应用与研究

Application of objective structured clinical examination to evaluation of the clinical skills

目的:研究应用客观结构化临床考试(objective structured clinical examination,OSCE)评价医学生临床技能水平的重要性。方法:采用在医学模拟人上实际操作的"三站式"OSCE考试,对我校2011、2012、2013届共计2 181名临床医学专业学生进行临床实践技能考核,并随机抽取三届部分学生与考官进行问卷调查。结果:OSCE考核成绩总体呈正态分布。与2011届学生成绩比较,2013届学生三站成绩、总成绩、及格率均明显降低(P<0.001)。问卷调查结果显示,85.7%考官与66.5%学生认为三站式考试能够客观全面考核医学生对临床基本技能的掌握情况;2012届93.9%考生认为OSCE毕业综合多站式考核应该继续坚持下去。结论:OSCE考核具有良好的信度、可操作性与重复性,能够客观、真实、全面评估考生的临床基本技能,值得进一步推广;OSCE对于加强与促进医学院校的临床实践教学,具有一定的导向作用。

Objective： To estimate the significance of applying objective structured clinical examination（ OSCE） to medical students in evaluation of their command of clinical skills. Methods： A total of 2 181 medical students enrolled in year of 2011,2012 and 2013,respectively,in Wannan Medical College underwent OSCE at three stations on medical human analogue basis for evaluation of their clinical practice skills. In process,some of the students and judges were randomly invited to complete a previously defined questionnaire for their comments. Results： The scoring on OSCE was normally distributed in general for the total students,and students enrolled in 2013 scored significantly lower compared with those enrolled in 2011 regarding the single performance,total scores and pass rate at the three stations（ P 〈0. 001）. The questionnaire statistics showed that 85. 7% of judges and 66. 5% of students considered three-station OSCE being capable of objective and comprehensive evaluation of students in the clinical practice skills,and 93. 9% students enrolled in2012 had the opinion that such examination modality should be maintained in the future. Conclusion： OSCE has a better reliability,operability and reproducibility,and is worthy of wider application for its objective,authentic and comprehensive measurement of the clinical skills of students. In addition,OSCE may play a guiding role in orientation and improvement of clinical teaching in medical colleges.