以提高临床实践能力为导向的出科OSCE实施探索  

Preliminary exploration of OSCE-test on completion of a course to improve students＇ clinical competence

作　　者：周金懿[1] 丁美琴[1] 徐文[1] 丁晓林[1] 孙书方[1] 陈卫昌[1] 

机构地区：[1]苏州大学附属第一医院/苏州大学临床技能实验教学中心,215006

出　　处：《中华医学教育探索杂志》2013年第11期1092-1095,共4页Chinese Journal of Medical Education Research

摘　　要：目的探索实习过程中提高医学生临床实践能力的有效途径。方法选取苏州大学2006级与2007级临床医学专业398名学生为研究对象。将分配至附属第一医院40人作为实验组，分配至其他实习医院的358人为对照组。实验组通过在常规实习管理过程中引入出科客观结构化临床考核（objective structured clinical examination，OSCE），引导学生开展自主学习、强化临床实践。对照组采用传统实习和考核方法。应用SPSS19．0软件包对学生操作考试成绩进行统计分析，采用配对样本t检验和独立样本t检验，计量资料以均分±标准差（x±s）表示，P〈0．05为差异有统计学意义。结果实验组40名学生实习前后的临床实践能力均有不同程度的提高。其中心电图判读、心肺听诊、问诊技巧、内科操作和外科操作成绩提高明显（P〈0．05）：实验组在毕业临床实践能力评估中的综合能力表现明显优于对照组总体水平（P〈0．05）。结论合理应用出科OSCE，使实习管理更有效，学生实习目的更明确，可有效促进和提高学生的临床实践能力。Objective To investigate the effective ways of improving medical students＇ clinical competence during the process of internship. Methods Totally 398 students of clinical medicine from 2006 and 2007 grade in Soochow University were enrolled as research objects. Forty objects distribut- ed to the First Affiliated Hospital were taken as experiment group while 358 objects distributed to other hospital as control group. In experiment group, objective structured clinical examination （OSCE） was introduced during regular internship, innovation was made on test on completion of a course and autonomous learning and clinical practice was advocated and enhanced. Traditional practice and ex- amination method was used in control group. SPSS 19.0 was used to do statistical analysis on the test scores of students. Paired sample t test and independent sample t test were employed. Measurement data is expressed as x ＋ s and P〈0.05 signifies statistically significant differences. Results Clinical practice ability of students in experiment group was enhanced to various degrees after internship com- pared with that before internship. ECG interpretation, heart and lung auscultation, interrogation tech- nique, medical and surgical operation performances of students in experiment group were promoted significantly （P〈0.05）. Students＇ overall competence in the final graduation skill test was better in ex- periment group than in control group （P〈0.05）. Conclusions OSCE-test on completion of a course not only make intern management more effective, but also make students＇ aim more definite, therefore it is conducive to enhancing clinical competence.

关 键 词：客观结构化临床考试 实践技能 临床实习 出科考试 

分 类 号：R-4[医药卫生]