工作场所评估在住院医师规范化培训中的应用  

Practice of Workplace Based Assessment for Resident Standardized Training

作　　者：李济时 吴平安 林莉莉 沈琳 黄少翚 Brian O'Sullivan 李咏梅 LI Jishi;WU Ping’an;LIN Lili;SHEN Lin;HUANG Shaohui;Brian O'Sullivan;LI Yongmei(Oncology Medical Center,the University of Hong Kong-Shenzhen Hospital,Shenzhen Guangdong 518000,China;Otolaryngology-Head and Neck Surgery,the University of Hong Kong-Shenzhen Hospital,Shenzhen Guangdong 518000,China;Department of Radiation Oncology,Princess Margaret Cancer Centre,Toronto M5G 2M9,Canada)

机构地区：[1]香港大学深圳医院肿瘤医学中心,广东深圳518000 [2]香港大学深圳医院耳鼻喉头颈外科,广东深圳518000 [3]玛格丽特癌症中心放射治疗科,加拿大多伦多M5G 2M9

出　　处：《中国继续医学教育》2023年第7期132-136,共5页China Continuing Medical Education

摘　　要：目的为观察住院医师规范化培训(简称"住培")过程中的临床胜任力并给予反馈,进行基于多学科病例讨论的工作场所评估。方法2021年8—12月,选择耳鼻咽喉头颈外科出院病例中1例扁桃体癌术后的典型案例,请19名参与住培的住院医师整理病史及所有临床资料进行汇报交流,邀请权威放射肿瘤科专家作为评估者,运用病例讨论工作场所评估工具,针对住院医师对于该病例的诊治过程中表现出的临床胜任力进行评价,并在会后进行复盘总结。结果住院医师在"诊断技巧与相关临床知识""临床判断""病历记录"项目上最常见被评价为"待发展",分别是73.7%、57.9%、36.8%。住院医师在复盘过程中反思了其在病例讨论过程中所暴露的不足,激发了其进一步提升临床胜任力的驱动力。结论基于病例讨论的工作场所评估有助于筛选出有待发展的胜任力目标,所呈现的典型病例、评价工具以及复盘,可以为放射肿瘤科、耳鼻咽喉头颈外科的住院医师规范化培训提供参考。Objective To observe the core clinical competencies during resident standardized training program and perform workplace based assessment for giving feedback to trainees.Methods From August to December 2021,a typical case of tonsil cancer after discharge from the department of otolaryngology-head and neck surgery was selected,19 resident physicians participating in residential training were invited to organize the medical history and all clinical data for reporting and exchange,authoritative radiation oncology experts were invited as evaluators,case based discussion and workplace evaluation tools were used.The clinical competence of resident physicians in the treatment of this case was evaluated,and a review was made after the meeting.Results Residents were most likely to be evaluated as"development required"in "diagnostic skills and underlying knowledge base" "clinical assessment" and "medical record keeping",which was 73.7%,57.9% and 36.8%,respectively.During the debriefing,the trainees reflect the performance gap during the presentation and discussion,and are motivated to improve all the competencies in the future.Conclusion Workplace based assessment of casebased discussion helps to screen out competencies that need to be developed.The typical case scenario,workplace based assessment tool,and debriefing during this teaching activity of case discussion produce positive effects and deserved to be applied in the resident training program in radiation oncology as well was otolaryngology-head and neck surgery.

关 键 词：住院医师规范化培训 临床胜任力 评估 放射肿瘤学 耳鼻咽喉科 扁桃体癌 

分 类 号：G642[文化科学—高等教育学]