基础医学与临床 ›› 2020, Vol. 40 ›› Issue (12): 1740-1743.

• 医学教育 • 上一篇    下一篇

口试在高年资麻醉住院医师自评和考评中的应用

于春华1, 李旭1*, 张越伦2, 权翔1, 阮侠1, 谭刚1, 黄宇光1   

  1. 1.中国医学科学院 北京协和医学院 北京协和医院 麻醉科;
    2.中国医学科学院 北京协和医学院 北京协和医院 医学科学研究中心, 北京 100730
  • 收稿日期:2019-05-12 修回日期:2020-03-28 出版日期:2020-12-05 发布日期:2020-11-30
  • 通讯作者: * lixupumch@163.com
  • 基金资助:
    北京协和医学院青年教师培养项目(2015zlgc0723);北京协和医学院研究生教学改革项目(10023201600102);北京协和医院临床骨干师资海外培训项目(2018PUMCHFDO-LX)

Application of oral examination in self-evaluation and evaluation of senior anesthesia resident

YU Chun-hua1, LI Xu1*, ZHANG Yue-lun2, QUAN Xiang1, RUAN Xia1, TAN Gang1, HUANG Yu-guang1   

  1. 1. Department of Anesthesiology;
    2. Medical Research Center,Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730, China
  • Received:2019-05-12 Revised:2020-03-28 Online:2020-12-05 Published:2020-11-30
  • Contact: * lixupumch@163.com

摘要: 目的 通过口试找出麻醉科高年资住院医师临床胜任力中的不足以及对比学生自评打分与考官打分的差异。方法 2018年至2019年对44名住院医师进行口试测试,参加考试的均为第3年住院医师,口试共20 min,考官针对具体病例就术前评估、术中管理、术后管理等问题提问。考试结束后,两名考官及考生分别对口试进行评分。结果 考官评分总体表现(多数时间)是(3.54±0.72)分,总体表现(少数时间)是(3.34±0.94)分。其中最高的是口头交流技巧符合住院医的年资(3.57±0.70)分,最低的两项分别是根据临床情况的改变调整治疗(3.28±0.77)分,及了解其他管理策略的优缺点(3.29±0.73)分。自评分总体表现(多数时间)是(3.17±0.63)分,总体表现(少数时间)是(3.09±1.12)分,自评分数最高的是交流信息有逻辑性且高效(3.34±0.81)分,自评分数最低的两项分别是了解其他管理策略的优缺点(2.84±0.75)分和根据临床情况的改变调整治疗(3.07±0.70)分。大多数(73%)考生评分成绩合格,自评分显著低于考官评分(P<0.05)。结论 多数3年级住院医师在口试中能表现出相应的水平,麻醉住院医师在根据临床情况的改变调整治疗和了解其他管理策略的优缺点方面有待加强。

关键词: 麻醉, 口试, 住院医, 考评, 自评

Abstract: Objective To assess the capability of senior residents in clinical competency, and to compare the difference between examiner grading and examinee grading. Methods 44 third year residents attended the oral examination in 2018 and 2019. The oral exam lasted 20 minutes covering questions from preoperative evaluation, intraoperative management, and to postoperative management. Two examiners participated in the oral exam. Results The examiners gave the grading of 3.54±0.72 for majority of the time, and gave the grading of 3.34±0.94 for minority of the time. The residents showed the best ability in oral communication skills appropriate for level in residency, and showed the poorest ability in being able to adapt to changes in the clinical situation 3.28±0.77 and understanding advantages and disadvantages of alternative management strategies 3.29±0.73. The examinee gave the grading of 3.17±0.63 for majority of the time, and gave the grading of 3.09±1.12 for minority of the time. The residents evaluated themselves the highest score in communicates information logically and effectively 3.34±0.81, and evaluated themselves the lowest score in being able to adapt to changes in the clinical situation 3.07±0.70 and understanding advantages and disadvantages of alternative management strategies 2.84±0.75. Most of the residents (73%) reached the score equal or more than 3. Examinees intended to underrate themselves significantly(P<0.05). Conclusions Most of the third year residents showed appropriate clinical competence acquired for this stage. Residents in anesthesia should practice more in understanding advantages and disadvantages of alternative management strategies and in being able to adapt to changes in the clinical situation. To improve the clinical competence, practice oral examinations should be instituted in the resident training programs in China.

Key words: anesthesiology, oral examination, resident, evaluation, self-evaluation

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