基于OSCE理念的“六站式”骨科临床技能考核体系的应用  

Research on Application of “Six-station” Evaluation System of Orthopedic Clinical Skill on the Basis of OSCE Concept

作　　者：刘劲松[1] 张锡华 李溪[1] 阮永华 杨丽娟 吴雪梅[1] 蒋萍 王琦[2] LIU Jin-song;ZHANG Xi-hua;LI Xi;RUAN Yong-hua;YANG Li-juan;WU Xue-mei;JIANG Ping;WANG Qi(Dept.of Orthopedics,First Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032;2nd Department of Orthopedics,First Affiliated Hospital of Yunnan Traditional Chinese Medicine College,Kunming Yunnan 650021;School of Basic Medical Sciences,Kunming Medical University,Kunming Yunnan 650500,China)

机构地区：[1]昆明医科大学第一附属医院骨科,云南昆明650032 [2]云南中医学院第一附属医院骨伤科二病区,云南昆明650021 [3]昆明医科大学基础医学院,云南昆明650500

出　　处：《昆明医科大学学报》2018年第9期137-141,共5页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(8120040;81360176;81760149);云南省高等学校教学改革研究基金资助项目(201605);昆明医科大学教研教改基金资助项目(2015-JY-Y-29;2016-JY-Z-02)

摘　　要：目的探索适用于昆明医科大学骨外科学研究生学位衔接培养模式的阶段性临床技能考核与教学质量评估体系.方法采用基于OSCE理念的"六站式"骨科临床技能考核体系对昆明医科大学第一附属医院2014届接受学位衔接培养模式的骨外科学研究生实施三个阶段的临床技能考核,通过对考核结果、考生回馈意见的比较分析,以明确各阶段考生临床技能的薄弱环节及教学中存在的不足,为教学改革指明方向,并探讨该考核体系的实用性、可行性.结果各考站平均成绩均逐年升高,通过对各考站不同阶段平均成绩的比较发现均存有差异(P<0.05);在每个考核阶段,第一站(病史采集、病例分析、体格检查)平均成绩均为最低,第三站(术前准备)次之,即两个NSP考站平均成绩均偏低,两两比较发现两站间无明显差异,但第一、三站与其他考站均存在差异(P<0.05);在两个NSP考站,医患沟通能力优良率最低;三个阶段的合格率分别为45.45%(5人)、72.73%(8人)、100.00%(11人),第三阶段合格率与住院医师规范化培训结业考核通过率存在一致性(100.00%,11人);考生对该核体系的预期前景均持乐观态度(非常乐观:36.36%;乐观:63.64%),一致认为阶段性实施该项考核对提升骨科综合临床技能是有益的,并对骨科NSP的"标准化"能力表示认可.结论该考核体系与住院医师规范化培训相接轨,可初步适用于昆明医科大学骨外科学研究生学位衔接培养过程中阶段性临床技能的考核和教学质量的评估,具有一定的借鉴、推广价值.Objective To explore the periodic evaluation system of clinical skills and teaching quality applicable to the training mode of postgraduate degree of orthopedics in Kunming Medical University. Methods A three-station clinical skills evaluation based on OSCE concept was performed among 2014 orthopedic Graduates and the evaluation result and feedback of candidates were comparatively analyzed to determine the weaknesses both in teaching and clinical skills of orthopedic candidates at different stages, thus to provide references for teaching reform and discuss the practicality and feasibility of the evaluation system. Results Based on the comparison of average scores at different stages of each examination station,it was found that the average scores of different examination stations increased year by year;Among all the stages,the first station（collection of medical history, case analysis and physical examination） had the lowest average scores, the third station（preoperative preparation）had the second lowest average scores, meaning that the average scores of two NSP examination stations was relatively low. On the basis of comparative analysis, it was found that there was no significant difference between the two stations,but there was a difference between station one,station three and other examination stations（P 〈 0.05）. The good rates of between doctors and patients were the lowest and the three stages were 45.45%（5）, 72.73%（8）, 100%（11） respectively. There was a consistency（100%, 11 people） in the assessment of standardized training for resident physicians（100%, 11 people）, and the candidates were optimistic about the prospect of the nuclear system（very optimistic： 36.36%;optimistic： 63.64%）. It was agreed that it was beneficial to improve the comprehensive clinical skills of orthopedics in the stage of implementation,and it also recognized the ＂standardization＂ ability of orthopedics NSP. Conclusion The evaluation system is in line with the standardized training of th

关 键 词：客观标准化临床考试 护士标准化患者 骨科 学位衔接 考核体系 应用研究 

分 类 号：G420[文化科学—课程与教学论]