利用计算机虚拟病人进行临床思维能力评价初探

Study on the evaluation of clinical reasoning ability by digital virtual patients

目的 探讨利用计算机虚拟病人对临床思维能力进行评价的有效性及其意义.方法 对在瑞金医院进行住院医师规范化培训的98名住院医师和八年制临床医学专业32名八年级学生采用计算机虚拟病人进行临床思维考核,考核后将计算机初步评估考核成绩与教师修改评估标准后的成绩进行比较分析.结果 修改评估标准后的成绩有显著提高,修改评估标准后的考核成绩明显优于计算机初步评估得到的评价成绩.结论 由计算机虚拟病人得出的初步评估考核成绩必须经过教师的修改调整,才能有效地进行临床思维评估,进一步的研究阐明了有效应用计算机虚拟病人的必要性.

Objective Study on the effectiveness and significance of evaluation on clinical reasoning ability by using virtual patients generated by computers.Method 98 resident doctors of the second-or-third-year residents standardized training in Ruijin Hospital and 32 eighth-year medical students under 8-year doctorate programs were assigned to the experiment.They were all first evaluated under the virtual patient exams and the grades were compared by two scoring systems,of which the first one is generated automatically by computer and the other is adjusted by the automated scores based on trainers＇ assessment.Results The adjusted scores are statistically significantly higher than the automated scores （original scores）.And,the overall grades are raised.Conclusions The automated scoring systems of digital virtual patient programs are not effectively valuable until the reassessments by the trainers,which the adjusted scores could better present the trainees＇ clinical and diagnostic reasoning ability.And this article also argues the necessity of the effectiveness in digital virtual patient programs.