引用本文:李艺 官涛 石钰 张静波 赵景宏 黄云剑.迷你临床演练评估在肾脏内科住院医师规范化培训中的应用研究[J].中华医学教育探索杂志,2019,18(9):957~
迷你临床演练评估在肾脏内科住院医师规范化培训中的应用研究
Application of mini-clinical evaluation exercise on standardized training of residents in department of nephrology
DOI:
中文关键词:  迷你临床演练评估  住院医师  肾内科  规范化培训
英文关键词:Mini-clinical evaluation exercise (Mini-CEX)  Resident physician  Nephrology  Standardized training
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作者单位
李艺 官涛 石钰 张静波 赵景宏 黄云剑 陆军军医大学第二附属医院肾内科 重庆 400037 
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中文摘要:
      目的 观察迷你临床演练评估(Mini-CEX)在肾内科住院医师规范化培训中的应用效果。方法 对2017年3月至2018年3月在我院肾内科规范化培训的80名住院医师运用Mini-CEX进行考核;考核内容主要包括病史采集、体格检查、临床诊断、治疗方案、医患沟通、人文关怀、临床整体能力7方面。同时对肾内科9名教师和上述80名住院医师进行Mini-CEX反馈问卷调查,内容包括教师和住院医师对Mini-CEX的看法和满意度。应用SPSS 21.0对组间数据比较行独立样本t检验。结果 通过Mini-CEX考核,住院医师的各项临床能力在规培结束时明显高于规培初期,差异均有统计学意义(P<0.05)。住院医师最大的提高表现在治疗方案、整体临床能力和体格检查方面。治疗方案考核结果显示,规培结束时住院医师平均得分为(7.525±1.062),明显优于规培初期平均得分(5.175±1.035),差异有统计学意义(P=0.000)。其次是临床诊断和人文关怀,住院医师培训后平均得分均高于培训初期(P<0.05)。临床诊断考核结果显示,规培结束时平均得分为(6.925±1.071),优于规培初期得分(5.425±1.238),差异有统计学意义(P=0.000)。教师和住院医师的Mini-CEX反馈问卷调查显示,教师认为Mini-CEX是一种较好的评估方式(88.9%),还可促进自身学习(77.8%)。住院医师认为Mini-CEX贴近临床实践,以病房和临床实践作为基础测评,考核内容较全面,可提高自身临床技能(85.0%)和综合素质(87.5%),对Mini-CEX整体满意度达92.5%。结论 Mini-CEX运用于肾内科住院医师规范化培训中,能有效提高住院医师的临床综合能力,有助于提高规培教学质量。
英文摘要:
      Objective To observe the effectiveness of mini-clinical evaluation exercise (Mini-CEX) on the standardized training of residents in the department of nephrology. Methods Mini-CEX was used to evaluate the 80 residents who received clinical standardized training in the department of nephrology from March 2017 to March 2018 in our hospital. The assessment mainly contained seven aspects: medical history taking, physical examination, clinical diagnosis, therapeutic regimen, doctor-patient communication, humanistic care, and overall clinical ability. Meanwhile, a Mini-CEX questionnaire was conducted among 9 teachers and 80 residents, including their viewpiont and satisfaction degree on Mini-CEX. The SPSS 21.0 was used for statistical analysis and the independent sample t-test was used for comparison between the two groups. Results Through the Mini-CEX assessment, every aspect of clinical competence of residents at the end of this program was significantly higher than that at the early period, and the difference was statistically significant (P<0.05). The most obvious improvement in residents was their treatment plan, overall clinical ability and physical examination. About the assessment of therapeutic regimen, the average score at the end of the training was (7.525±1.062), which was better than before (5.175±1.035), and the difference was statistically significant (P=0.000). Besides, clinical diagnosis and humanistic care were significantly better than those at the beginning (P<0.05). About the assessment of clinical diagnosis, the average score after the training was (6.925±1.071), which was better than before (5.425±1.238), and the difference was statistically significant (P=0.000). According to results of Mini-CEX questionnaire, teachers thought that Mini-CEX was a better way of assessment (88.9%) and could promote self-learning (77.8%), while residents believed that Mini-CEX was close to clinical practice and the ward-or-practice-based assessment was relatively comprehensive, which could significantly improve clinical skills (85.0%) and comprehensive quality (87.5%), with a satisfaction degree of 92.5%. Conclusion Mini-CEX is applied in the standardized training of residents in the department of nephrology, which can effectively improve clinical comprehensive ability of residents and improve Self-learning of teachers.
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