多样化评估方法在麻醉医师规范化培训中的应用

Xia Ruan, L. Pei, Xu Li, Yu Zhang, Chunhua Yu, Jie Yi, Yuguang Huang
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摘要

目的探讨多元化考核体系在麻醉学不同学位住院医师规范化培训中的应用,为提高住院医师核心能力提供参考。方法选取2016年9月至2017年8月麻醉科住院医师58人,其中A组临床研究生25人,B组博士学位14人,c组本科学位19人。设计并构建了由季度选择题考试、临床工作注册制、不定期日常绩效考核和年度OSCE临床技能考核组成的多元化考核体系。以医疗知识、病人护理、专业精神、沟通技巧和技术技能5项核心能力为评分标准,绘制每位住院医师核心能力雷达图。比较不同群体住院医师五项核心竞争力的差异。结果三组住院医师专业能力[(4.27±0.75)vs(4.55±0.51)vs(4.32±0.67)]和患者护理能力[(4.00±0.60)vs(4.17±0.64)vs(3.97±0.62)]差异均无统计学意义(P>0.05)。医学知识得分[(4.13±0.36)vs(4.12±0.34)vs(3.72±0.44)]、沟通能力得分[(3.71±0.34)vs(4.02±0.24)vs(3.75±0.32)]、技术技能得分[(4.15±0.27)vs(4.43±0.17)vs(4.19±0.18)]、胜任力总分[(20.25±1.67)vs(21.29±1.41)vs(19.95±1.38)]差异均有统计学意义(P<0.05)。通过分析不同程度住院医师雷达图的形状和特征,可以发现A组住院医师沟通能力相对较弱的最为常见(A组12人),B组住院医师临床能力相当的最为常见(B组8人);C组医学知识贫乏者最多(8人)。结论多元化的评价体系有助于对规范化培训住院医师核心能力进行综合评价;不同程度住院医师的核心能力表现不同,需要根据住院医师的不同特点在培训过程中予以重点关注。关键词:麻醉学;规范化住院医师培训;多元化的评价;核心竞争力
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Application of diversified evaluation methods in standardized training of anesthesiologists
Objective To study the application of diversified assessment system on standardized training of residents with different degrees in anesthesiology, so as to provide reference for improving their core competence. Methods Fifty-eight residents in anesthesiology department from September 2016 to August 2017 were selected, including 25 clinical graduate students in group A, 14 residents with doctoral degree in group B and 19 residents with Bachelor's degree in group C. Designed and built a diversified assessment system consisting of quarterly multiple choice question examinations, clinical work registrations system, irregular daily performance evaluations and annual OSCE clinical skills assessments. The five core competencies including medical knowledge, patient care, professionalism, communication skills and technical skills were evaluated by all these scores, and the radar chart of core competencies is drawn for each resident. Compared the differences of five core competencies among residents in different groups. Results There were no significant differences in the competency of professionalism[(4.27±0.75)vs(4.55±0.51)vs(4.32±0.67)] and patient care[(4.00±0.60)vs(4.17±0.64)vs(3.97±0.62)] among residents in 3 different groups(all P>0.05). There were significant differences in scores of medical knowledge[(4.13±0.36)vs(4.12±0.34)vs (3.72±0.44)], communication ability[(3.71±0.34)vs(4.02±0.24)vs(3.75±0.32)], technical skills[(4.15±0.27)vs(4.43±0.17)vs(4.19±0.18)] and total scores of competencies [(20.25±1.67)vs(21.29±1.41)vs(19.95±1.38)] (all P<0.05). By analyzing the shape and characteristics of radar chart of residents with different degrees, it can be found that the relatively weak communication skills of residents in group A is the most common (12 people in group A), in group B, the equal clinical competencies of residents is the most common (8 peoplein group B), the poor medical knowledge in group C is the most common (8 people in group C). Conclusions The diversified evaluation system is helpful for the comprehensive evaluation of the core competence of the standardized trainging residents; the performance of core competencies of residents with different degree is different, which needs to be focused on in the training process according to the different characteristics of the residents. Key words: Anesthesiology; Standardized resident training; Diversified evaluation; Core competency
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