规模客观结构化临床考试组织与实施的探索

Scale exploration to the organization and implementation of objective structured clinical examination

目的在实习结束后对临床医学生进行客观结构化临床考试(objective structured clinical examination,OSCE),探索客观评估医学生临床能力的方法。方法受试对象为济宁医学院2014届和2015届临床医学专业本科学生1831名。考试由两部分组成,分别为标准化病人(standardized patients,SP)站和非标准化病人站,学生依次通过各考站,全部考站结束完成考试,考试过程中注重考官对学生的当面反馈,并对考试结果进行分析。结果 2015届学生的SP问诊和外科、妇产科操作技能、辅助检查结果判读、病历书写成绩高于2014届学生,2015届学生操作熟练程度及规范性、交流技巧、爱伤观念评分成绩优良,表现出了较高的医德医风。结论加强医学生在临床实习过程中的技能操作培训和指导,不断优化OSCE,可以对其临床能力进行全面客观评估,提高其临床技能操作水平和综合素质,从而为其今后的临床实践打下良好基础。

Objective Through OSCE for medical students after their internship,to explore methods for objec-tively assessing medical students＇clinical ability.Methods We took 1831 undergraduate students of Jining Medical University as respondents.The examination consisted of two parts,namely standardized patient （Standardized Pa-tients,SP）stations and non-standardized patient station.When students completed all the test stations in proper se-quences,their test results were analyzed.And examiners should pay attention to the feedback face to face.Results The medical records of 2015 students were higher than those of 2014 in inquirying,operation skills,interpreta-tion of test results and taking medical records.The 2015 students showed better proficient and normative opera-tion,communication skills,the sense of injury-loving and a higher medical ethics.Conclusion OSCE could conduct a comprehensive and objective assessment of medical students＇clinical capabilities at the end of their internship,and could be conducive to improve students＇comprehensive skills and future clinical practice.