迷你临床演练评估在以病例为基础的临床见习教学中的应用

Application of Mini-CEX in case-based clinical probation teaching

目的探讨迷你临床演练评估(Mini-clinical evaluation exercise,Mini-CEX)在以病例为基础的临床见习教学中的应用效果。方法采用试验对照方法。选取2018年2月至2019年1月进行临床见习的哈尔滨医科大学2015级五年制临床医学专业60名学生为研究对象。采用抽签方式随机将其分为试验组和对照组,每组30名学生。在临床见习教学中,试验组实施Mini-CEX,对照组实施传统评价方式。见习结束后,比较两组学生临床诊疗能力和试验组学生对Mini-CEX的满意度。结果试验组学生与对照组学生的病史询问评分分别为(7.77±0.82)分、(7.10±1.21)分,体格检查评分分别为(7.40±0.81)分、(6.83±0.99)分,人文关怀评分分别为(7.30±1.12)分、(6.07±1.89)分,临床判断评分分别为(7.47±0.86)、(6.77±1.48)分,沟通技能评分分别为(7.77±0.86)分、(6.93±1.53)分,组织效能评分分别为(7.20±0.61)分、(6.57±1.10)分,整体表现评分分别为(8.13±0.68)分、(7.40±1.19)分,其差异均具有统计学意义(均P<0.05)。问卷结果表明,93.3%(28/30)的试验组学生对Mini-CEX满意。结论Mini-CEX应用于临床见习,可以提高学生的见习质量。

Objective To explore the application effect of Mini-CEX in clinical probation teaching based on cases.Methods Experimental control method was used in this study.Sixty undergraduates of five-year program enrolled in 2015 in Harbin Medical University who was taking clinical probation from February in 2018 to January in 2019 were selected as the research objects.The students were randomly divided into control group and experimental group distributing with 30 in each.In clinical probation teaching,Mini-CEX evaluation method was used in the experimental group and traditional evaluation method was used in the control group.After the probation,comparing two groups for clinical diagnosis and treatment,and collect the comment from experimental group about students'satisfaction about Mini-CEX evaluation.Results The scores of medical history inquiry of experimental group and control group were(7.77±0.82)and(7.10±1.21),respectively;The physical examination scores were(7.40±0.81)and(6.83±0.99)respectively;The scores of humanistic care were(7.30±1.12)and(6.07±1.89)respectively;The clinical judgment scores were(7.47±0.86)and(6.77±1.48)respectively;The scores of communication skills were(7.77±0.86)and(6.93±1.53)respectively;The scores of organizational effectiveness were(7.20±0.61)and(6.57±1.10)respectively;The overall performance scores were(8.13±0.68)and(7.40±1.19)respectively;The differences were statistically significant(all P<0.05).The questionnaire results show that 93.3%(28/30)of the experimental group students are satisfied with the Mini-CEX method.Conclusions The application of Mini-CEX method in clinical probation can improve the quality of student probation.