Mini-CEX在基层全科医师临床基础能力培养中的应用  

Application of Mini-CEX in the training of clinical basic competence of general practitioners in primary care facilities

作　　者：潘云菲[1] 赵费敏[1] 沈玲芳 Pan Yunfei;ZhaoFeimin;Shen Lingfang(General Medicine Department,Huzhou Central Hospital,Affliated Central Hospital,Huzhou University,Huzhou 313000,Zhejiang,China;General Medicine Department,Yang Jia Bu Community Health Service Centre,Huzhou 313000,Zhejiang,China)

机构地区：[1]湖州市中心医院/湖州师范学院附属中心医院全科医学科,浙江湖州313000 [2]杨家埠街道社区卫生服务中心全科,浙江湖州313000

出　　处：《中国毕业后医学教育》2022年第6期530-533,共4页Chinese Journal of Graduate Medical Education

基　　金：浙江大学医学院2020年教育改革项目《医共体背景下同质化全科医师培养模式的探索》(jgyb20202051)。

摘　　要：目的探讨迷你临床演练评估(mini-clinical evaluation,Mini-CEX)在基层全科医师临床基础能力培养中的应用效果。方法选择该院医联体内72名基层全科医师作为研究对象,随机分为观察组和对照组,各36名。观察组每月1次临床诊疗实践并按Mini-CEX进行评估,从病史采集、体格检查、临床判断、临床处理、人文关怀、沟通技能、专业素质、组织效能、整体表现等方面表现进行个体化的评价、反馈,给予个性化指导、帮助;对照组每月1次临床诊疗实践,不按Mini-CEX进行评估,仅从病史采集、体格检查、临床处理等方面的共性问题进行反馈。每次临床诊疗完成后两组均接受患者满意度调查,每两月进行1次临床基础能力考核,观察期12个月。结果采用重复测量方差分析分别对两组临床基础能力及患者满意度进行比较。结果显示,从第5次临床基础能力考核(即实验8个月后)和第7次患者满意度调查开始(即实验7个月后),两组差异有统计学意义(P<0.05)。结论Mini-CEX可提升基层全科医师临床基础能力及患者满意度,教学效果良好。Objective Objective To explore the application effect of Mini-Clinical Evaluation(Mini-CEX) in the training of clinical basic competence of general practitioners(GPs)in primary care facilities.Methods We chose 72 GPs in primary care facilities as subjects who were just in the medical community leaded by Huzhou Central Hospital.All the subjects were randomly divided into the experimental group and the control group,each group containing 36 GPs.The experimental group took clinical diagnosis and treatment practice once a month and was evaluated according to Mini-CEX.They were given individual evaluation and feedback from aspects of history-taking,physical examination,clinical judgment,clinical treatment,humanistic care,communication skills,professional competence,organizational ability and overall performance,receiving individual instruction and help.While the control group took clinical diagnosis and treatment practice once a month and were not evaluated according to Mini-CEX,only taking feedback on common problems from aspects of history-taking,physical examination and clinical treatment.After the clinical process,all the GPs received patients’satisfaction survey and were tested for clinical basic competence every two months in one year.Results Repeated-measure ANOVA was used to compare the clinical basic competence and patients’satisfaction survey of two groups.Data analysis showed that,from the fifth clinical basic competence assessment(8 months after the experiment)and the 7th patients’satisfaction survey(7months after the experiment),there was a statistically significant difference between two groups.Conclusion MiniCEX can improve the clinical basic competence and the patients’satisfaction of GPs in primary care facilities,with good teaching effect.

关 键 词：迷你临床演练评估 全科医师 临床能力 评估 

分 类 号：G30-034[文化科学] R4[医药卫生—临床医学]