改进版Mini-CEX在八年制《皮肤性病学》见习教学中的应用  

Application of modified mini-clinical evaluation exercise(Mini-CEX)in probationary teaching of dermatology and venereology for eight-year program students

作　　者：谢阳[1] 朱国兴[1] 夏悦[1] 郑跃[1] Xie Yang;Zhu Guoxing;Xia Yue;Zheng Yue(Department of Dermatology and Venereology,The Third Affiliated Hospital,Sun Yat-Sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院皮肤性病科,广州510630

出　　处：《中华医学教育探索杂志》2023年第6期916-919,共4页Chinese Journal of Medical Education Research

基　　金：2019年度广东省临床教学基地教学改革研究项目(2019JD005)。

摘　　要：目的探讨改进版Mini-CEX在八年制《皮肤性病学》见习教学中的应用。方法2019至2020年在中山大学附属第三医院八年制《皮肤性病学》见习教学中,58名学生在见习前、中、后期,分别接受改进版Mini-CEX评估各1次。具体改进内容体现在细化各项评估指标,其中病史采集方面包括皮疹的动态变化、有鉴别诊断意义的阴性症状和既往史/个人史/家族史等重要病史;体格检查方面包括皮疹专科情况、系统体格检查和有鉴别诊断意义的阴性体征;人文关怀方面包括关爱患者、健康教育和隐私保护;临床判断方面包括诊断、鉴别诊断和治疗原则;沟通技巧方面包括熟练程度、主次分明和肢体语言;组织效能方面包括时间分配、患者依从性和准备工作;整体表现方面包括镇定流畅、书写整洁和初步的临床思维。采用SPSS 20.0进行t检验。结果58名八年制学生见习中、后期时的临床综合能力测评成绩均有提高,各个子项评估,后期与前期比较,评分均有提高(P<0.001);其中皮疹的动态变化、皮疹专科情况(皮疹的辨别与描述)等具有专科特色。结论改进版Mini-CEX是一种客观、全面、简洁、高效的评估工具,符合《皮肤性病学》教学改革和实践的需求。Objective To investigate the application of modified mini-clinical evaluation exercise(Mini-CEX)in the probationary teaching of dermatology and venereology for eight-year program students.Methods From 2019 to 2020,a modified Mini-CEX was used to grade 58 eight-year program students at the Third Affiliated Hospital of Sun Yat-Sen University at the early,middle,and late stages of the probationary teaching of dermatology and venereology.The modifications included refining various evaluation indicators.Specifically,medical history collection involved dynamic changes in rashes,negative symptoms with differential diagnostic significance,past history/personal history/family history,and other important medical history;physical examination involved the specialized condition of rashes,systematic physical examination,and negative signs with differential diagnostic significance;humanistic care involved caring for patients,health education,and privacy protection;clinical judgment involved principles of diagnosis,differential diagnosis,and treatment;communication skills involved proficiency,prioritization,and body language;organizational effectiveness involved time allocation,patient compliance,and preparation work;overall performance involved calmness and fluency,neat writing,and preliminary clinical thinking.SPSS 20.0 was used to perform the t test.Results Compared with the early stage of probation,the 58 eight-year program students improved their scores in clinical comprehensive ability evaluation and scores in each specific evaluation at the middle and late stages of probation(P<0.001).The dynamic changes in rashes and the specialized situation of rashes(identification and description of rashes)were specific to this discipline.Conclusion The modified Mini-CEX is an objective,comprehensive,concise,and efficient assessment tool,which meets the needs of teaching reform and practice of dermatology and venereology.

关 键 词：皮肤性病学 迷你临床演练评估 见习教学 八年制 

分 类 号：R-05[医药卫生]