标准化病人的培训及其在临床教学与考核中的应用

为了满足现代医学生的培养目标,结合我院情况,探讨标准化病人(Standardized Patient,SP)作为患者、评估者和指导者所采取的培训形式,将标准化病人应用于临床教学、临床技能训练及考核中,达到提高学生临床思维能力、临床技能及沟通技巧的目的。     

德国汉诺威医学院汉尼拔医学课程模式探析

德国汉诺威医学院创立的汉尼拔医学课程模式是一种特殊的医学教育模式，本文从入学选拔、培养目标、课程设置、临床教学、课程考核、教学管理与评价这六个方面对其进行剖析。严格的选拔标准和学医动机考核是准入条件；人才培养以德国国家医学能力框架设定的医学学习目标为指导，注重以患者为中心、以科学研究为导向、以实用为原则；课程设置模块化，课程内容丰富，临床实践开展早；教学过程实行以疾病研究为中心的“学习螺旋”与三级化教学，提供高度跨学科的临床实训；采用客观结构化临床考试是课程考核的主要特点；在教学质量保障上，有受法律保护的教学质量监控管理体系和教学评估监督机制。     

建设OSCE技能考核体系的应用与评估——广东医科大学2018届毕业生OSCE考核情况的调查报告

客观结构化临床考试(Objective Structured Clinical Examniation,OSCE)是一种客观的、有序的、有组织的考核框架,能通过模拟临床场景来测试医学生的临床能力,也是一种知识、技能和态度并重的临床能力评估的方法。OSCE在国外开展较早,在我国也已经有20年左右的探索经验。我校近年来建设OSCE考核模式融入毕业生毕业考核,既能改变毕业考核“重理论、轻实践”的局面,又能促进学生加强技能操作训练。文章着重评估了广东医科大学2018届毕业生首次使用OSCE进行毕业考核的实际效果与现存的问题。     

What is an objective structured practical examination in anatomy?

Assessing teaching‐learning outcomes in anatomical knowledge is a complex task that requires the evaluation of multiple domains: theoretical, practical, and clinical knowledge. In general, theoretical knowledge is tested by a written examination system constituted by multiple choice questions (MCQs) and/or short answer questions (SAQ). The assessment of practical knowledge (three‐dimensional anatomical concepts) involves oral, spot, or objective structured practical examinations (OSPE). Finally, the application of anatomical knowledge to patients is tested mainly through objective structured clinical examinations (OSCE). The major focus of this study is the OSPE. Although many schools challenge students using this tool in practical examinations in the early phase of the curriculum, the true meaning of OSPE is frequently forgotten and it becomes, in reality, a spot examination. This article, for the first time, describes how the concept of the OSPE has evolved and is currently being used to assess the practical domain of anatomical knowledge in a problem‐based curriculum at Alfaisal University College of Medicine. In addition, it describes the main differences from the spot examination, which is normally used in traditional medical curricula. The authors believe that the OSPE remains the most efficient tool to assess the practical aspects of anatomical knowledge in a system where basic knowledge is integrated with the clinical or functional part of anatomy. However, this contention only holds true if the OSPE process revolves around structured objectives. Anat Sci Educ 6: 125–133. © 2012 American Association of Anatomists.     

基于SP/OSCE康复技能考核体系的改革和探索

本文主要探讨SP/OSCE视角下学生康复技能考核体系的改革以及探索。文章首先对当前学生康复技能考核体系中存在的问题进行简要概述;接着分析了SP/OSCE应用到学生康复技能考核中的重要意义;进而研究了基于SP/OSCE的康复技能考核体系的建设;最后文章对SP/OSCE康复技能考核体系中存在的不足以及相应的完善措施进行阐述。     

探索基于OSCE的渐进式出科考核方法在临床医学教学管理中的应用

临床医学教学的目的是培养具有临床基础知识、临床思维和技能的医师,如何评估和检测培养的人才是否掌握相关的知识和技能尤为重要。出科考核是加强临床教管理、监控临床教学质量的重要方法。该文基于OSCE模式对医学生出科考核方式进行改良,以期客观公正反映学生的能力,以考促学和以考促教,从而实验培养高素质的医学人才。     

The trouble with resits …

In the criterion‐based clinical assessment context, and more broadly, examination resits continue to present an ongoing dilemma to educators. The number of students involved is generally a small percentage of the cohort, but it is precisely with these students that institutions bear a heavy responsibility in ensuring they reach a sufficiently high standard of performance, and are accurately assessed. The students must be given a “fair” opportunity to reach the appropriate standard(s), but at the same time, especially when clinical skills are being assessed, the public must be protected from incompetent practitioners. However, this creates a delicate tension for institutions since resits present an additional financial burden, and student failures adversely effect external funding.

This paper investigates and compares the main clinical assessment and resit profiles of students in two medical schools, each of which employs a different standard setting methodology. The analysis demonstrates that resit students improve their performance by a substantial amount; this finding applies across all undergraduate clinical levels. The key issue under investigation is whether resits, as currently constituted, offer an unfair advantage to the resit student. In essence, are resits are too easy?     

基于翻转课堂教学模式的OSCE考核成绩分析

目的:分析翻转课堂教学模式下客观结构化临床技能考试(Objective Structured Clinical Examination,OSCE)学生成绩,根据各项操作掌握度情况找出临床技能教学中存在的问题,进而改进教学.方法:在海南医学院2015级临床医学本科的临床技能强化培训中采用翻转课堂教学模式,通过OSCE各站点成绩来评价翻转课堂教学模式下的教学效果.结果:第三站的心肺复苏得分最高,第二站体格检查得分最低;22个项目中掌握优秀的占13.64%,包括眼球运动检查、心肺复苏、语音震颤检查;掌握较差的占22.73%,包括测脉搏,右肺下界移动度检查、简易呼吸器、缝合打结.结论:翻转课堂模式下的OSCE考核成绩处于中等水平,学生对各项技能的掌握不一.在以后的教学中需要有的放矢,针对薄弱环节重点施教,提高技能教学效果.     

The weak relationship between anatomy competence and clinical skills in junior medical students

In modern curricula, the early integration of anatomy and clinical skills education at undergraduate level is seen as important. However, the direct relationship between medical students' competence in anatomy, and their clinical proficiency during early undergraduate years, has scarcely been studied. In this study, the marks for anatomy and clinical skills of three consecutive cohorts of medical students (n = 538 in total) during their first two years were correlated. The anatomy competence was measured using a new marker, the Anatomy Competence Score (ACS) which was calculated with equal contributions from theory knowledge and its practical and clinical application. Proficiency in clinical skills was determined by OSCE performance marks for stations which examined physical examination and practical procedural skills. The possible compounding effect of students' general academic ability was investigated by using the overall performance mark for each student based on their performance in all subjects over the first two years of the medical curriculum. We found that the correlation between anatomy and clinical skills marks was weak to moderate. However, this correlation was virtually nullified once the effect of academic ability was accounted for. Although these findings suggest that anatomy education does not compliment early clinical education, the lack of complexity of clinical problems used in clinical skills assessments (OSCEs) during the early stages may well be the primary contributing factor to this finding.     

OSCE模式在综合实验教学中的发展现状及趋势

目前,医学服务模式强调以病人为中心,病人有权选择医院及医师,病人自我保护意识增强.在临床的教学工作中经常出现病人拒绝向学生提供病史,拒绝体格检查,学生的实践机会明显减少等问题,从而达不到目前医学教育的目的.OSCE是伴随这一情况出现的一种新兴的考试方式.本文对OSCE的概况、在实际应用中的优缺点、发展趋势进行论述.