中西医结合迷你临床演练评估标准化评分的应用探索

Preliminary study on the construction of Mini-CEX scoring system of integrated traditional Chinese and western medicine standardization

目的探索具有中西医结合专业特色的迷你临床演练评估(mini-clinical examination exercise,Mini-CEX)标准化评分的应用,以改善临床实习和考核的效果。方法2016年1月至2016年12月,选择在上海中医药大学附属岳阳中西医结合医院实习的上海中医药大学2012级五年制中西医结合专业40名学生为研究对象,采用随机数字表法将其分为试验组和对照组,每组20名学生。试验组实施标准化Mini-CEX考核方式,对照组实施传统Mini-CEX考核方式。统计分析两组学生考核成绩,并对两组学生和带教教师的问卷调查结果进行分析。结果试验组学生考核的整体成绩[(2.45±0.88)分]低于对照组学生[(4.65±0.67)分],其差异具有统计学意义(P<0.01)。相对于Mini-CEX传统考核方式,教师在"评分依据明确"等方面对标准化Mini-CEX考核评分更高[(7.90±0.56)分比(2.90±1.37)分],其差异具有统计学意义(P<0.01);学生在"教师点评更为清晰""对中医问诊方法有新体会"等方面对标准化Mini-CEX考核评分更高[(5.95±2.08)分比(1.50±0.60)分、(4.20±0.69)分比(2.15±1.26)分],其差异均具有统计学意义(均P<0.01)。结论标准化Mini-CEX评分标准的制定有助于保证考核和教育教学的公平和严谨性。

Objective A set of standardized Mini-CEX scoring standards with characteristics of traditional Chinese medicine is planned to be applied to the clinical practice assessment of medical students in our hospital, so as to improve the clinical practice and assessment efficiency.Methods From January 2016 to December 2016, 40 students of 2012 five-year program of Shanghai University of Traditional Chinese Medicine majoring in Integrated Traditional Chinese and Western Medicine, who were interned in Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, were divided into standardized group and traditional group by random number table method, with 20 students in each group. The standardization group implements the standardized Mini-CEX assessment method, while the traditional group implements the traditional Mini-CEX assessment method. Statistical analysis of the two groups of students assessment results, and students and teachers of the questionnaire survey results were analyzed.Results The Mini-CEX score of standardized group was lower than that of traditional group[(2.45±0.88)vs(4.65±0.67), P<0.01]. Compared with the traditional assessment method of mini CEX, teachers scored higher on standardized Mini-CEX in terms of "clear scoring basis" [(7.90 ± 0.56) vs (2.90 ± 1.37) , P<0.01];students scored higher on standardized Mini-CEX in terms of "clearer teacher's comments" and "new experience in TCM consultation method" [(5.95±2.08)vs(1.50±0.60), (4.20±0.69)vs(2.15±1.26), all P<0.01].Conclusions The establishment of standardized Mini CEX scoring standards helps to ensure the fairness and preciseness of assessment and education and teaching, so as to improve the quality of teaching.