形成性评价在医学生临床实习中的应用探索

The application of formative assessment in medical students’clinical practice

临床实习是医学教育中极为重要的阶段,直接影响到医学人才的培养质量。形成性评价(formative assessment)是学习者在主动建构知识的过程中,为引导教学正确有效地进行,而对教师教学和学生学习的效果所进行的评价。其目的主要是通过在教学实施过程中经常性、阶段性地向教师和学生反馈教学信息,使他们充分利用这些评价信息,适时采取措施矫正、改进教学进程,使教学成为一个不断自我修正的系统,以提高教学质量。为了提高临床实习期间带教教师教学质量和实习学生学习效果,本文对应用形成性评价进行了探索,在同一实习计划、同一实习内容、同一教学方式、同一评价手段的前提下,合理构架临床实习评价体系,分别在实习前、实习中和实习后3个阶段开展评价,利用评价反馈信息,不断改进实习进程。实习前评价包括实习计划评价、技能准入评价、教学基地条件评价等细化内容;实习中评价包括学生自我评价(包括实习日志、病例技能项目记录等)、学生小组互评(包括学习态度、学习方法等)、师生评价(示教方式、操作能力、沟通能力、医德医风等)、学校抽评(医疗文书书写、实习日志、基本操作等)和教学基地组织评价(学习态度、教学态度、知识能力、出科考核等);实习结束后评价包括自我总结评价、小组互评、教学基地总鉴定评价。九江学院医学部4年来的实践表明,临床实习中实施形成性评价可以规范和改善临床教师教学内容与教学方法,提高学生学习积极性与主动性,提升医学生临床实习教学质量。

Clinical practice was a very important stage in medical education,which directly affected the training quality of medical talents.Formative assessment referred to the evaluation of teachers’teaching and students’learning effects in order to guide teaching to be carried out correctly and effectively in the process of actively constructing knowledge.It mainly aimed at feeding back teaching information to teachers and students regularly and periodically in the process of teaching implementation.To make full use of the evaluation information,timely take measures to correct and improve the teaching process,so that teaching become a self-correcting system to improve the quality of teaching.In order to improve the teaching quality of doctors and the learning effect of medical students during the internship,in this paper,the beneficial exploration on the application of formative assessment had been carried out and a reasonable evaluation system in the same internship program,the same practice contents,the same teaching methods and the same evaluation had been made.The whole process of practice was divided into three stages of evaluation before,during and after practice,and the evaluation feedback information was used to continuously improve the process of practice.The evaluation before practice included detailed contents such as evaluation of practice plan,evaluation of skill admittance and evaluation of teaching site conditions.The evaluation during practice included student self-evaluation(including practice log,case skill project record,etc.),student group evaluation(including learning attitude,learning method,etc.),teacher and student evaluation(demonstration method,operation ability,communication ability,medical ethics,etc.),school evaluation(medical document writing,practice log,basic operation,etc.),and evaluation of teaching sites(learning attitude,teaching attitude,knowledge ability examination,etc.).The evaluation after the internship covered self-summary evaluation,group evaluation,teaching site general evaluation.Through the five-year practice of formative evaluation reform in clinical practice in Jiujiang University,it was proved to be of great significance to standardize the teaching content and teaching methods of clinical teachers,improve students’learning enthusiasm and initiative,and improve the quality of clinical practice.