迷你临床演练评量在肾内科实习医师和住院医师规范化培训中的应用

Using mini clinical evaluation exercise in clinical practice teaching of advanced undergraduate students and standardized training of residents in department of nephrology

在肾内科实习医师和住院医师规范化培训基地住院医师培养中推行迷你临床演练评量(Mini-CEX),对169名学员在入科时及每2-4周进行一次Mini-CEX评估。结果显示住院医师和实习医师出科时从医疗面谈、体格检查、沟通技能、临床判断、人文关怀,组织效能和整体表现7个方面较入科时均显著提高。实践结果显示肾脏病临床教学中引入mini-CEX评估可提高住院医师和实习医师的综合素质。

Objective：To evaluate the effectiveness of mini clinical evaluation exercise（Mini-CEX）in clinical practice teaching of advanced undergraduate students and standardized training of residents in department of nephrology. Methods Sixty advanced undergraduate medical students and 109 residency trainees, who participated in clinical practice teaching or standardized training in department of nephrology during June 2014 to June 2016, were included in this study. Clinical practice students received conventional teaching and additional 2 rounds of Mini-CEX in 2 weeks, and the residency trainees received conventional teaching and additional 2 rounds of Mini-CEX in 2 months. Results Scores in all items （medical history, physical examination, counseling skills, clinical judgment, humanistic qualities, organization, and overall evaluation） at the last evaluation were significantly higher than that of the first time （ P 〈 0.01）. Conclusion Our study demonstrate that Mini-CEX value both knowledge and skills,mutually promote training and evaluation, and intensify humane quality culture, which are worth popularizing in clinical teaching and training.