Development of Standard Examination System of Special Course for Remote Education

Standard examination is an effective approach to promote the teaching quality of modern education. On terms of the analysis of main target, function and constitution of special course examination system for remote education, the internet scheme of the examination system is given according to the students and teachers' requirements. The implementation method for the communication and dynamic production of tests on home page of the exam system are elaborated by using programming technology of Active Server Pages (ASP)3.0. The query of exam information and automatic marking of test questions can be easily realized by the developed exam system under World Wide Web enviromment according to users' requirements.

Attitudes of undergraduate nursing students toward Objective Structure Practical Examination: An Exploratory study

Background: Objective Structured Practical Examination (OSPE) is a method of assessment of clinical competence.The examination is conducted at multiple stations.Besides practical and problem-solving skills,theoretical knowledge is also tested.OSPE can be traced back more than 40 years.OSPE has been included more than two decades,as a part of assessment in the College of Nursing,All India Institute of Medical Sciences (AIIMS),New Delhi.Objectives: This study was carried out to determine nursing students' attitudes towards OSPE as an assessment tool.Participants: The responses of all the 252 Undergraduate nursing students studying at the College of Nursing,AIIMS were obtained for this study (77 from B.Sc.(H) Nursing first year,61 from the second year,69 from the third year and 45 from the fourth year).Methods: The students attitudes towards OSPE were assessed by using a validated questionnaire containing 28 item statements on Likert's 5-point scale (LS) and 11 bipolar adjectives on Osgood's 7-point Semantic'Differential Scale (OSDS).Result: Most of the students approved of OSPE and felt that it was fair,useful,good,effective,exciting,interesting,practical,skill oriented but also taxing.The study also revealed that amongst the second years' students there was a strong correlation between Overall Rank in the Class and Assessment of OSPE.Conclusion: The study supports the introduction of OSPE as one of the methods of assessment of B.Sc.(Hons.) Nursing students.

Constructing the Training Curriculum of Standardized Patients for OSCE Examination for Undergraduate Nursing Students in Shanxi Medical University

Objective: The objective of this study is to construct the simulated patient training curriculum for OSCE examination for undergraduate nursing students and to explore the theoretical and practical foundation. Methods: To establish TSP training curriculum and SSP training curriculum, 30 experts were invited to finish the questionnaires which were proved by Delphi Method. Findings: We established the training curriculum of TSP and SSP, and set the weight of various curricula and teaching contents. Conclusions: The experts considered that the degree and importance of these two training curricula were comparable. This conclusion lays the foundation for applying these curricula to teaching practice and clinical practice, and enhancing the teaching outcome of undergraduate nursing students. Implications: This study provided a new way of assessing the clinic ability of nursing students.

Analysis on the results of graduate examination for standardized medical residency training in general hospital---- Takes The First Affiliated Hospital of Kunming Medical University as an example

[ 目的] 对昆明医科大学第一附属医院（ 以下简称昆医附一院）2016 -2017年住院医师规范化培训结 业综合考核结果进行分析和总结,查找培训过程中存在的问题,提出提高住院医师规范化培训质量的建议. [方法] 将云南省住院医师规范化培训管理平台中公布的昆医附-院2016 - 2017年住院医师规范化培训结业综 合考核的结果录入Excel, 按照考试站点各专业考核情况进行分类统计,并对数据进行分析.[结果] 各站点考 试的合格率分别为综合知识部分95.26%,辅助检查部分88.23%,病史采集部分97.64%,体格检查部分 96. 14% ,病例分析部分97.21%,临床操作部分94.21%,门诊病例书写部分97.42%,医患沟通部分98.07%. 各专业综合考核第-阶段的不合格率：最高的为泌尿外科63. 64 %,最低的为内科学6.25%.各专业综合考核 第二阶段的不合格率：最高的为神经内科33.33%,最低的为超声科6. 67 %.[结论] 结业考核结果中,除辅助 检查部分外,其余七站均达到90 %以上的合格率,说明辅助检查判读的部分是该院参培住院医师的薄弱环节, 应加强检查结果判读培训,以确保提高住院医师规范化培训的综合质量.

Test anxiety in objective structured clinical examinations (OSCEs) compared with traditional assessment methods in undergraduate midwifery students

BACKGROUND: Final comprehensive exam is the most important examination for midwifery students to evaluate their professional ability and Test anxiety is a common phenomenon among college students. Because test anxiety is one of the problems of educational systems, this study was performed to compare test anxiety in objective structured clinical examinations (OS-CEs) and traditional assessment methods (TAM) among Undergraduate Midwifery Students. Methods: In this descriptive-analytical study, 52 students of Babol Midwifery College were participated in the study. 20 students were evaluated using TAM in November 2010, and 32 students were evaluated using the OSCE method in July 2011. Data were collected via a two-component questionnaire including demographic data and the test anxiety inventory (TAI). Results: All of midwifery students were women;the mean age of students, ages of father and mother’s were 23.1 ± 0.7, 52.3 ± 3.5 and 47.8 ± 4.9 years, respectively. Most of the students were single (61.5%). The mean education levels of father and mother’s were 11.6 ± 4.5 and 9.9 ± 4.0 years, respectively. The mean score of test anxiety in students was 42.51 ± 13.16. The most of participants did have moderate test anxiety (56.9%), two present not had any test anxiety, 37.3% had low test anxiety, and 3.9% had severe test anxiety. In sum, 98% had some degrees of test anxiety. There were the statistical differences in the mean score of text anxiety in OSCEs Compared with TAM in Undergraduate Midwifery Students (39.38 ± 13.81 vs. 47.35 ± 10.67, P = 0.033). Also, the mean severity of anxiety was different in two groups. The mean of moderate/severe test anxiety was more in TAM compared with OSCEs (52.57% vs. 49.56%, p = 0.000). The test anxiety had a positive correlation with father’s education, mother’s education (0.286, p = 0.042), father’s age, mother’s age, marital status, residency (0.292, p = 0.042). Also, there are negative correlations with student age, satisfaction, total Grade Point Average (GPA) (-0.387, p = 0.007), final score, type of assessment (-0.298, p = 0.033). There is a significant difference between the severity anxiety residency in total (p = 0.10) and OSCEs (p = 0.049) groups, mother’s education in total (p = 0.005) and OSCEs groups (0.012) and GPA (p = 0.028). Conclusion: OSCEs were superior to TAM in the reduction of test anxiety in midwifery students. The prevalence of test anxiety was in TAM than OSCEs method;therefore, using OSCEs is acknowledged as an effective assessment tool and is seen as the gold standard for evaluating clinical performance.

ISHD:Intelligent Standing Human Detection of Video Surveillance for the Smart Examination Environment

In the environment of smart examination rooms, it is important to quickly and accurately detect abnormal behavior(human standing) for the construction of a smart campus. Based on deep learning, we propose an intelligentstanding human detection (ISHD) method based on an improved single shot multibox detector to detect thetarget of standing human posture in the scene frame of exam room video surveillance at a specific examinationstage. ISHD combines the MobileNet network in a single shot multibox detector network, improves the posturefeature extractor of a standing person, merges prior knowledge, and introduces transfer learning in the trainingstrategy, which greatly reduces the computation amount, improves the detection accuracy, and reduces the trainingdifficulty. The experiment proves that the model proposed in this paper has a better detection ability for the smalland medium-sized standing human body posture in video test scenes on the EMV-2 dataset.

Attitudes of Nursing Faculty Members and Graduates towards the Objective Structured Clinical Examination (OSCE)

The aim of this study was to evaluate the attitudes of faculty and graduates of college of nursing towards Objective Structured Clinical Examination (OSCE) as a valid and reliable method of clinical competency assessment in nursing ten years after its inception. Core nursing courses are based on instructional teaching methods and “hands-on” approach to impact cognitive, psychomotor skills and clinical judgments. Different clinical competency assessment methods are used globally;however, most of them are subjective. A descriptive survey using 16-item five-point likert scale questionnaire was conducted. The study sample consisted of 140 participants: 20 faculty members, 27 graduates of the Bachelor of Science in Nursing (BSN) Degree and 93 graduates of the Associate Degree of Nursing (ADN) programs with OSCE experience during their training. Data collection was carried out between October and November 2015. Eighty percent of faculty members, 74% of BSN and 62.3% of ADN graduates agreed that OSCE represented an objective evaluation method for psychomotor skills. Majority of the graduates perceived their OSCE experience positively although stressful. However, they have suggested the introduction of trial/mock OSCE prior to each exam to minimize the stress associated with it. In conclusion, there appears to be no single “gold-standard” assessment tool for clinical competency. OSCE assesses student nurses’ psychomotor skills in a non-clinical environment, therefore without risks to real patients. In combination with other assessment methods in the clinical settings, OSCE will provide a more comprehensive student psychomotor skill evaluation. OSCE experiences gave new nursing graduates confidence to work as registered nurses in health care settings.

The Research of Examination Paper Generation Based on Index System Metrics and Multi-Objective Strategy

Since the examination paper generated with computer by the algorithms of random and backtracking takes on inferior quality and inefficient, and the question of generating examination paper with computer has the character of multi-ob-jective because of the index system metrics, the genetic algorithm with multi-objective strategy optimization is proposed to solve this problem. Mapping the index system to multi-objective functions and optimizing the computing with multi-objective strategy are employed in the algorithm. The genetic algorithm experiment based on the multi-objective strategy optimization shows that the result has the advantages getting tradeoff between performance and quality, and having the ability to tune the performance and quality to meet the user’s requirements.

Establishment of an Objective Standard for the Definition of Binary Tropical Cyclones in the Western North Pacific

To develop an objective standard for defining binary tropical cyclones(BTCs)in the western North Pacific(WNP),two best-track datasets,from the China Meteorological Administration and the Joint Typhoon Warning Center,were adopted for statistical analyses on two important characteristics of BTCs-two TCs approaching each other,and counterclockwise spinning.Based on the high consistency between the two datasets,we established an objective standard,which includes a main standard for defining BTCs and a secondary standard for identifying typical/atypical BTCs.The main standard includes two requirements:two coexisting TCs are a pair of BTCs if(i)the separation distance is≤1800 km,and(ii)this separation maintains for at least 12 h.Meanwhile,the secondary standard defines a typical BTC as one for which there is at least one observation when the two TCs approach each other and spin counterclockwise simultaneously.Under the standard,the ratio of typical BTCs increases as the BTC duration increases or the minimum distance between the two TCs decreases.Then,using the JTWC dataset,it was found that there are 505 pairs of BTCs during the period 1951−2014,including 328 typical BTCs and 177 atypical BTCs,accounting for 65.0%and 35.0%of the total,respectively.In addition,a study of two extreme phenomena-the maximum approaching speed and the maximum counterclockwise angular velocity in typical BTCs-shows that the configuration of the circulation conditions and the distribution of the BTCs favor the formation of these extreme phenomena.

教师模拟标准化病人联合临床医师技能培训考试系统教学模式应用于住院医师规范化培训中的效果

目的探讨教师模拟标准化病人(TSP)联合临床医师技能培训考试系统(OSCE)教学模式应用于住院医师规范化培训(以下简称“规培”)中的效果。方法选取2022年8月至2023年8月在潍坊医学院附属医院接受规培的住院医师60名,按随机抽签法分为两组,对照组30名培训过程中应用传统教学模式,研究组30名培训中应用TSP联合OSCE教学模式。比较两组规培医师培训前后的培训效果、综合能力及对规培医师对教学模式认同度。结果研究组培训后的理论、实践操作成绩均高于对照组,差异有统计学意义(P<0.05)。研究组培训后的迷你临床演练评估(Mini-CEX)、批判性思维能力测量表(CTDI-CV)评分均高于对照组,差异有统计学意义(P<0.05)。研究组规培医师对教学模式的认同度高于对照组,差异有统计学意义(P<0.05)。结论TSP联合OSCE教学模式应用于住院医师规培中可有效提升其成绩及综合能力,且规培医师对此教学模式的认同度较高。

中医医院新入职本科护士培训考核评价指标的构建

目的 构建中医医院新入职本科护士培训考核评价指标。方法 通过文献研究、小组讨论,建立中医医院新入职本科护士培训考核评价指标初稿,选取来自7个省份的中华护理学会中医中西医结合护理分会的15名专家进行2轮专家咨询,确定考核评价内容及其权重。结果 2轮专家函询问卷的有效回收率均为100%,专家权威系数分别是0.962、0.980,肯德尔协调系数分别是0.220、0.268(均P<0.05),最终形成的中医医院新入职本科护士培训考核评价指标包括5项一级指标、24项二级指标和77项三级指标。结论 构建的中医医院新入职本科护士培训考核评价指标具有较高的可靠性和科学性,可为中医医院管理者及培训者选拔人才提供参考。

新课标中核心素养对“双基”“三维目标”的继承与超越

继承与超越是把握核心素养与“双基”“三维目标”关系的两个关键词。素养导向的新课标承认知识在教育中的基础性地位,各学科着重培育的核心素养普遍以中国学生发展核心素养为统率,以各学科知识和技能为基础。“三维目标”在拓展教育目标的全面性等方面超越“双基”,核心素养在将知识、技能、方法、情感等课程教学目标看作有机整体等方面进一步超越“双基”和“三维目标”,核心素养语境中的知识观和技能观在强调基于真实情境的应用与生成等方面较以往有了很大进步。聚焦核心素养,新时代课程教学改革应该在继承基础上超越,构建兼容“双基”与“三维目标”的核心素养结构模型,直观呈现三者的内在统一关系;合理定位聚焦核心素养的单元和课时教学目标,抓准教学设计的“牛鼻子”;基于多种教学方式的相辅相成培育核心素养,丰富课堂教学组织形式。

基于客观结构化临床考试的情景模拟式教学在手术室专科护士培训中的应用

目的探讨基于客观结构化临床考试(objective structured clinical examination,OSCE)的情景模拟式教学在手术室专科护士培训中的应用效果。方法选取参加郑州大学第一附属医院手术室专科护士培训的78名学员为研究对象。按照培训时间先后顺序,将2021年4月-6月参加培训的40名学员作为对照组,将2022年4月-6月参加培训的38名学员作为观察组。对照组采用常规情景模拟式教学,观察组采用基于OSCE的情景模拟式教学,比较2组操作考核成绩、临床思维能力。结果观察组操作考核中患者核查交接、手术体位安置、职业暴露防护的考核成绩均好于对照组(t=4.616,P<0.001;t=3.004,P=0.004;t=3.574,P=0.001),观察组临床思维能力得分高于对照组(t=7.309,P<0.001)。结论将基于OSCE的情景模拟式教学应用于手术室专科护士培训,有助于提高其操作技能和临床思维能力,值得临床推广应用。

基于OSCE考试成绩的临床基本技能教学同质化分析

目的:查找和改进临床医学专业学生临床实践教学中的薄弱环节,提高实践教学质量。方法:以沈阳某医学院校在12个实践教学基地实习的2016级临床医学专业参加毕业技能考试的291名实习学生作为研究对象,采用单因素方差分析和Kruskal-Wallis检验分析其客观结构化临床考试(objective structured clinical examination,OSCE)的临床基本技能成绩。结果:在标准化病人问诊及查体成绩中,H实践教学基地的及格率和平均分均最低,其实习学生的平均分与A、B、F、G、K、L实践教学基地实习学生比较差异有统计学意义(P<0.01)。在技能操作成绩中,H实践教学基地及格率和平均分最低,其实习学生的平均分与A、D、E、F、G、I、J、K实践教学基地实习学生比较差异有统计学意义(P<0.01)。在辅助检查结果判读成绩中,H实践教学基地及格率和平均分最低,A、H基地实习学生的平均分与B、J基地实习学生的平均分比较差异有统计学意义(P<0.01)。结论:不同实践教学基地的学生实习效果存在较大差异,医学院校要加强对实践教学基地的管理,确保临床实践教学质量同质化。

影像检查规范化及管理体系建设与实施

基于“健康中国”战略的正式实施,为响应我国“十四五”时期党中央以及国务院对于人民群众医疗高质量发展的要求,通过优化医疗资源的利用效率,降低就医负担,并保障医疗质量以及安全;其内容包括影像检查规范化。本研究基于文献查阅以及江苏省影像规范化执行现状提出建设性意见和建议;影像检查规范化需要行政部门和医疗机构的体系支撑,同时还要有行业以及设备厂家的技术保障;行政主管部门制定和定期更新符合我国国情的影像指南以及具体实施细则,加强影像平台数据库建设,建立影像检查管理与评估体系,加大影像质控覆盖范围。医疗机构基于影像检查指南以及相关制度,强化培训并严格落实考核制度,执行影像检查和报告的智能质控和评价系统;开设独立的影像门诊或多科室联合门诊,提高临床诊疗的科学性和精准性。医务人员加强学习和执行相关检查指南以及实施细则,基于多学科诊疗平台提高规范化影像检查水平,积极开展影像新技术的研发和应用,提高影像检查的高效性和诊断的精准性。通过制定统一的符合我国国情和时代的影像指南以及影像工作实施细则,执行具体规范措施和方案,大力推进影像检查规范化。

义务教育英语课程语言能力目标落实之路径

本文基于《义务教育英语课程标准(2022年版)》对语言能力的界定及其提出的语言能力目标要求,结合英语教学的现状及未来发展趋势,就如何落实课程标准规定的语言能力目标提出以下建议:加强和优化显性语言知识的教学;在课堂教学中开展语言实践活动;将语言能力与其他核心素养的培养紧密融合;优化英语语言能力的评价方式。

规范化体检管理流程对健康体检人群满意度及不良事件的影响

目的 探讨规范化体检管理流程对健康体检人群满意度及不良事件的影响。方法 选取2021年8月—2022年8月到佛山市中医院健康管理中心体检的74名健康人群为研究对象,依据随机数字表法分为2组,各37名。对照组采用常规体检流程,观察组采用规范化体检管理流程。比较2组体检时间及健康知识掌握评分、满意度评分及不良事件发生率。结果 观察组健康知识掌握评分高于对照组,体检时间短于对照组(P<0.05);观察组满意度评分包括健康宣教(8.36±0.65)分、沟通能力(8.21±0.92)分、主动服务(9.16±0.21)分、护理礼仪(9.18±0.32)分,高于对照组的(6.62±1.21)、(6.45±1.35)、(8.26±0.56)、(8.05±0.45)分,差异有统计学意义(P<0.05)。观察组不良事件总发生率低于对照组(P<0.05)。结论 规范化体检管理流程应用在健康体检人群体检中效果明显,可缩短体检时间,提高体检满意度,减少不良事件发生率。

基于“虚实结合”的护理OSCE训练考核一体化模式探索与实践

以培养学生解决临床实际问题的思维能力为核心,护理客观结构化临床考试(OSCE)考核为主线,探索基于“虚实结合”的护理OSCE训练考核一体化模式。该模式包括线上护理OSCE虚拟训练平台和线下护理OSCE综合能力考核模式。建设OSCE考核病案库和SP剧本。线上开发虚拟仿真项目,搭建护理OSCE虚拟训练平台,训练学生临床思维能力;线下结合SP和仿真训练进行OSCE综合能力考核,强化学生技能操作、团队配合和护患沟通能力。设计即时评价、阶段评价和终末评价的多元教学评价体系,通过多元评价反馈,不断优化教学模式。该模式解决了实践教学的痛点问题,提升了学生综合实践能力,为院校深化护理实践教学改革和提高护理人才培养质量提供借鉴。

PDCA循环结合模拟考核在儿科住院医师结业临床实践能力考核的应用

目的探讨PDCA循环结合模拟考核在儿科专业基地住院医师规范化培训(简称住培)结业临床实践能力考核的应用。方法选择该院儿科专业基地参加住培结业实践技能考试的26名住院医师作为研究对象。在考前采取模拟考试、模拟考核结果反馈和座谈,发现住培管理中两个薄弱环节:平时缺乏病历书写的锻炼,在规定时间内很难完成病历书写;临床病例分析不完善,在接诊患者和临床病例分析方面的能力需要提高。要求儿科专业基地住院医师每月书写大病历2份,必须有指导医师修改痕迹。采取PDCA(计划、执行、检查、处理)循序持续改进。结果该院儿科专业基地住培结业实践技能考核通过率100.00%。结论运用PDCA循环结合模拟考核利于儿科专业基地住院医师结业实践技能考核。

OKR在检验医学住院医师规范化培训中的应用探讨

随着检验医学的高速发展,临床实验室得到了新的诠释,检验科不再仅限于执行标本收集、检验分析、结果报告等技术性工作,而应转变为一个能够为疾病诊疗提供实验室诊断信息的重要诊断科室。其需要积极主动参与到临床疾病的预防、诊断、治疗、预后评估等医疗活动中。检验医师作为一支新兴的医疗队伍应运而生,其角色不仅仅是技术执行者,更应充当实验室与临床医疗间的桥梁。在这个背景下,如何更好地进行检验住院医师规范化培训成为亟待解决的重要问题。本文通过对检验住院医师规范化培训内容的分析,探讨了目标与关键成果法(objectives and key results,OKR)在住培中的应用价值和意义。这一方法旨在明确培训的具体目标,并通过关键成果的达成来评估培训的有效性。借助OKR,不仅可以更加精准地设定检验医师培训的目标,而且可以在培训过程中更好地衡量和监控实际的学习成果,能够促进检验医学专业的规范化发展,培养更具综合素养和专业技能的医学人才。