“多站式”Mini-CEX评估法在急诊医学规培教学改革中的应用及效果评价

Evaluation of the Application and Effectiveness of the Multiple-station Mini-CEX Evaluating during the Educational Reform for Emergency Medicine for Standardized Training

目的探索多站式Mini-CEX评估法应用于急诊规培教学的效果及可行性。方法选取60名规培医师,随机分为A组和B组,A组(30名)予急诊医学传统的教学方法进行教学,B组(30名)予传统方法结合多站式Mini-CEX评估法进行教学。规培结束时,将B组出科和入科时的Mini-CEX评估法考核成绩进行比较,随后将A、B两组的Mini-CEX评估法出科考核成绩以及规培医师对教学的满意度进行比较。结果 B组在医学面谈技能、查体技能、人文素质/专业精神、临床判断、沟通技巧、条理性/效率、临床综合能力的出科考试成绩,以及该组带教教师、规培医师对本次评估的满意度评分均分别高于入科考试,差异有统计学意义(P<0.05);在医学面谈技能、查体技能、人文素质/专业精神、临床判断、条理性/效率、临床综合能力6个维度的出科考试成绩,以及该组带教教师、规培医师对本次评估的满意度评分均高于A组,差异有统计学意义(P<0.05)。B组对教学形式、教学效果的满意度评分均高于A组,差异有统计学意义(P<0.05)。结论多站式Mini-CEX评估法应用于急诊规培教学可提高规培医师的临床技能,该教学改革方法具备可行性。

Objective To investigate the feasibility and effect of the multiple-station Mini-CEX evaluating used for the teaching of standardized training in emergency medicine.Methods 60 standardized training doctors were divided randomly into two groups.30 standardized training doctors in group A were taught using the traditional teaching method in emergency medicine,and the others in group B were taught using the method of traditional teaching method combined with the multiple-station Mini-CEX evaluating.At the end of the standardized training,we compared the Mini-CEX evaluating score between the entrance and after-department examination of group B,the Mini-CEX evaluating score of the after-department examination between two groups,and the satisfaction with the teaching method of the standardized training doctors between the two groups were also evaluated.Results In group B,the score of after-department examination scores were all significantly higher than the entrance examination scores on medical interviewing skills,physical examination skills,humanistic qualities/professionalism,clinical judgement,counselling skills,organization/efficiency and overall clinical competence,and the satisfaction score of both teachers and standardized training doctors(P<0.05).6 after-department examination scores of medical interviewing skills,physical examination skills,humanistic qualities/professionalism,clinical judgement,organization/efficiency and overall clinical competence,and the satisfaction evaluating of both teachers and standardized training doctors were all significantly higher in group B comparing to group A(P<0.05).The satisfaction scores of the teaching mode and teaching effect for standardized training doctors were significantly higher in group B(P<0.05).Conclusion The multiple-station Mini-CEX evaluating used for the teaching and standardized training in emergency medicine may improve the clinical skills of standardized training doctors,and thus this teaching reform was feasible.