重症消化系统疾病应用Mini-CEX形成性评价在住院医师规范化培训教学管理中的应用

Application of Mini-CEX Formative Evaluation in the Teaching Management of Resident Standardized Training for Severe Digestive System Diseases

目的观察重症消化系统疾病应用迷你临床评估练习(Mini-CEX)形成性评价在住院医师规范化培训教学管理中的应用。方法选取2021年10月至2022年5月在本科的36名住培医师为研究对象,制定MiniCEX量表。在入科第1周时对住培医师进行Mini-CEX量表规范化测评,测评时间20~30 min,然后带教老师进行问题反馈,住培医师针对存在的问题进行整改和反复练习,在轮转最后1周时,再次进行测评,并最终统计得分。另在出科时,发放自行设计的《Mini-CEX教学法问卷反馈调查表》由住培医师独立完成,要求在5~10 min完成,当场回收问卷。结果重症消化系统疾病患者以年龄≥60岁的男性为主,其中大部分为再次住院患者。通过Mini-CEX测评后医疗面谈/病史采集、体格检查、人文关怀/医德医风、中西医诊治、医患沟通、组织效能、整体表现/临床胜任力等评分均明显升高(P<0.05)。结论对重症消化系统疾病应用Mini-CEX,在住培医师学习中是易于接受和实用性较强的测评工具。

Objective:To observe the application of mini-clinical assessment exercise(Mini-CEX)in the formative evaluation of severe digestive system diseases in the teaching management of resident standardized training.Methods:36 resident training physicians in our department from October 2021 to May 2022 were selected as the research subjects,and the Mini-CEX scale was formulated. The Mini-CEX scale was standardized evaluated for the resident doctors in the first week of enrollment,and the evaluation time was 20~30 minutes. Then the teacher gave feedback to the problems,and the resident doctors corrected the existing problems and practiced repeatedly.In the last week of rotation,the resident doctors were evaluated again,and the final score was calculated. In addition,when leaving the department,the self-designed Mini-CEX Teaching Method Questionnaire Feedback was distributed and completed by the resident training doctors independently,which was required to be completed within5~10 minutes,and the questionnaire was collected on the spot. Results:The patients with severe digestive system diseases were mainly male aged ≥60 years,and most of them were re-hospitalized. The scores of medical interview/history collection,physical examination,humanistic care/medical ethics,diagnosis and treatment of traditional Chinese and western medicine,doctor-patient communication,organizational effectiveness,overall performance/clinical competency were significantly increased after Mini-CEX assessment(P < 0.05). Conclusion:The application of Mini-CEX in the study of severe digestive system diseases is an easy to accept and practical evaluation tool.