应用Kappa（κ）指数辅助长学制妇产科临床技能培训的研究  

Application of Kappa（K） index in clinical training for eight-year program medical students

作　　者：赵超[1] 田莉[1] 刘春兰[1] 王建六[1] 魏丽惠[1] 

机构地区：[1]北京大学人民医院妇产科,100044

出　　处：《中华医学教育探索杂志》2012年第12期1215-1218,共4页Chinese Journal of Medical Education Research

基　　金：北京大学人民医院教学改革基金

摘　　要：目的运用统计学参数Kappa指数筛查出妇产科专科体检和操作中技术因素比重较大的体检项目，根据客观数据，结合学生与教师的主观感受综合评价Kappa指数应用于长学制妇产科临床教学的效果和意义。方法应用双盲法对妇产科专科体检和操作分项目进行Kappa指数筛查。建立教师水平体检操作的Kappa指数表，并对首轮实习的长学制医学生建立Kappa指数表。将实习医学生随机分为常规教学组（26人）及教改组（29人）。常规教学组按照传统跟随带教教师进行实习，教改组根据Kappa指数值进行有重点培训；培训后再次考核。注重对各个学生的薄弱项目进行个性化辅导及与学生交流心得。结果实施不同教学方法后，根据技能考核的Kappa指数，发现产科四步触诊检查，初学者不易迅速掌握。但妇科体检操作方面，两组成绩差异有统计学意义（P=0．016）。结论应用Kappa指数可筛查出长学制医学生妇产科临床教学中适宜培训的操作技能，并通过量化评估，达到指导教学改革、提高妇产科临床实习教学质量的目的。Objective To screened out items with large proportion of technical analysis in ob- stetrics and gynecology physical examination by using statistical parameters Kappa index and to evaluate effect and clinical significance of Kappa index based on objective data and students＇ and teachers＇ sub- jective feeling. Methods We made Kappa index screening with double-blind method and established the Kappa index table for teachers and students. Students were randomly divided into conventional teaching group （n =26） and teaching reform group （n =29）. Students in conventional teaching group traditionally followed the teacher to carry on the practice while those in teaching reform group received training according to the numerical value index and had examination after training. We paid attention to each student＇s weak points, provided personalized guidance and communicated with students actively. Results We found that it was uneasy for beginners to quickly grasp four step obstetrics palpation in- spection according to Kappa index. There were statistical differences in operation of gynecological phys- ical examination between two groups （P = 0. 016 ）. Conclusions Application of Kappa index can help us screen out skills in the operation suitable for training for eight-year program medical students. With quantitative evaluation, we can improve quality of clinical practice teaching in department of ob- stetrics and gynecology and guide educational reform.

关 键 词：Kappa指数 长学制医学生 妇产科实习 临床技能培训 

分 类 号：R36[医药卫生—病理学]