OSCE在全科住院医师儿科学规范化培训结业考核中的应用效果评价  

Evaluation of the Application Effect of Objective Structured Clinical Examination(OSCE)in the Graduation Assessment of Pediatric Training for General Practice Residents

作　　者：李琳霞[1] 寸丽苹[1] 张娴[1] 张黎黎[1] 王松[1] 杨霞 李艳红[1] Li Linxia;Cun Liping;Zhang Xian;Zhang Lili;Wang Song;Yang Xia;Li Hongyan(Second Affiliated Hospital of Kunming Medical University,Kunming 650101,Yunnan,China)

机构地区：[1]昆明医科大学第二附属医院,云南昆明650101

出　　处：《中国高等医学教育》2024年第5期54-56,59,共4页China Higher Medical Education

基　　金：昆明医科大学教研教改课题(编号2021-JY-Y-087)。

摘　　要：目的:评价客观结构化临床考试(objective structured clinical examination,OSCE)在全科医学专业儿科住院医师规范化培训结业考核中的应用效果。方法:采用OSCE对2018年至2020年进入儿科接受住院医师规范化培训的403名全科医师进行结业综合考核,考核结束后采用问卷调查了解考生对本次OSCE实施的评价。结果:本次OSCE的总体难度系数为0.78,区分度为0.67,信度为0.93,效度为0.70,病史询问站点难度最低,辅助检查结果判读站点难度最大,各站点的区分度均大于0.500。2018年至2020年考生OSCE总成绩分别为(83.5±4.7)分、(85.2±5.1)分和(86.5±4.4)分,考核通过率也都在90%以上,且呈逐年递增(χ^(2)=10.27,P<0.05);5个站点中,以儿科临床基本技能操作站点和辅助检查结果判读站点得分较低,其余3个站点得分较高,差异有统计学意义(F=16.71,P<0.05)。问卷调查结果显示,91.5%(352/385)的考生认为实施OSCE非常有必要,82.6%(318/385)的考生认为考核的站点设计合理,81.5%(314/385)的考生认为考核组织实施有序,75.6%(291/385)的考生认为考核难度适中,90.2%(347/385)的考生认为考核对今后临床工作有帮助。结论:OSCE能够真实模拟临床环境,有效评价全科医学专业住院医师的儿科临床综合技能,值得推广应用。Objective:To evaluate the application effect of objective structured clinical examination(OSCE)in the graduation assessment of pediatric training for general practice residents.Methods:OSCE was used to comprehensively assess 403 general practice residents who entered pediatric training from 2018 to 2020.After the assessment,a questionnaire survey was conducted to understand the candidates evaluation of this OSCE implementation.Results:The overall difficulty coefficient of this OSCE was 0.78,the discrimination coefficient was 0.67,the reliability was 0.93,and the validity was 0.70.The difficulty of the medical history taking station was the lowest,while the interpretation of auxiliary examination results station was the highest.The discrimination coefficients of all stations were greater than 0.500.The OSCE total scores of candidates from 2018 to 2020 were(83.5±4.7)points,(85.2±5.1)points,and(86.5±4.4)points,respectively,and the pass rates were all above 90%,showing an increasing trend year by year(χ^(2)=10.27,P<0.05).Among the 5 stations,the scores of basic pediatric clinical skills operation and interpretation of auxiliary examination results stations were lower,while the scores of the other 3 stations were higher,and the differences were statistically significant(F=16.71,P<0.05).The results of the questionnaire survey showed that 91.5%(352/385)of candidates believed that implementing OSCE was very necessary,82.6%(318/385)believed that the station design of the assessment was reasonable,81.5%(314/385)believed that the organization and implementation of the assessment were orderly,75.6%(291/385)believed that the difficulty of the assessment was moderate,and 90.2%(347/385)believed that the assessment would be helpful for future clinical work.Conclusion:OSCE can simulate the clinical environment realistically and effectively evaluate the comprehensive clinical skills of general practice residents in pediatric training,which is worthy of promotion and application.

关 键 词：客观结构化临床考试 评价 住院医师规范化培训 儿科学 全科医学 

分 类 号：G642[文化科学—高等教育学]