中华医学教育探索杂志
中華醫學教育探索雜誌
중화의학교육탐색잡지
Chinese Journal of Medical Education Research
2014年
6期
563-566
,共4页
赵晓华%黎志宏%薛志敏%聂建洪
趙曉華%黎誌宏%薛誌敏%聶建洪
조효화%려지굉%설지민%섭건홍
临床实习%临床技能%效果%评价
臨床實習%臨床技能%效果%評價
림상실습%림상기능%효과%평개
Clinical practice%Clinical skills%Effects%Evaluation
目的:评价内科实习考核指标体系,分析实习效果的影响因素。方法由专家组按照临床教学大纲和考核目的制定的内科学临床技能考核指标体系包括病史采集、体格检查、入院记录和病例提问4个项目。选取五年制临床医学专业49名实习生参加内科学考核的资料,利用信度、效度、区分度、难度分析内科学考核体系质量,采用两独立样本t检验和Wilcoxon秩和检验,从学生性别、实习医院和是否考研等方面分析实习效果的影响因素。结果考核指标体系信度为0.50,区分度为0.15,难度为0.85;病史采集、体格检查、入院记录、病例提问的去项目α系数为0.38、0.26、0.47、0.53,区分度为0.18、0.17、0.27、0.37,难度为0.87、0.89、0.79、0.78。女生考核总分、病史采集和体格检查得分高于男生(P<0.05);不同医院实习的学生成绩差异无统计学意义(P>0.05);未考研学生总分高于考研学生,差异有统计学意义(P<0.05)。结论本次考核体系合理,结果可靠,学生临床技能掌握较好,但仍需规范病例提问考核;实习医院因素对实习效果影响不大,学生性别、是否考研两因素影响实习效果。
目的:評價內科實習攷覈指標體繫,分析實習效果的影響因素。方法由專傢組按照臨床教學大綱和攷覈目的製定的內科學臨床技能攷覈指標體繫包括病史採集、體格檢查、入院記錄和病例提問4箇項目。選取五年製臨床醫學專業49名實習生參加內科學攷覈的資料,利用信度、效度、區分度、難度分析內科學攷覈體繫質量,採用兩獨立樣本t檢驗和Wilcoxon秩和檢驗,從學生性彆、實習醫院和是否攷研等方麵分析實習效果的影響因素。結果攷覈指標體繫信度為0.50,區分度為0.15,難度為0.85;病史採集、體格檢查、入院記錄、病例提問的去項目α繫數為0.38、0.26、0.47、0.53,區分度為0.18、0.17、0.27、0.37,難度為0.87、0.89、0.79、0.78。女生攷覈總分、病史採集和體格檢查得分高于男生(P<0.05);不同醫院實習的學生成績差異無統計學意義(P>0.05);未攷研學生總分高于攷研學生,差異有統計學意義(P<0.05)。結論本次攷覈體繫閤理,結果可靠,學生臨床技能掌握較好,但仍需規範病例提問攷覈;實習醫院因素對實習效果影響不大,學生性彆、是否攷研兩因素影響實習效果。
목적:평개내과실습고핵지표체계,분석실습효과적영향인소。방법유전가조안조림상교학대강화고핵목적제정적내과학림상기능고핵지표체계포괄병사채집、체격검사、입원기록화병례제문4개항목。선취오년제림상의학전업49명실습생삼가내과학고핵적자료,이용신도、효도、구분도、난도분석내과학고핵체계질량,채용량독립양본t검험화Wilcoxon질화검험,종학생성별、실습의원화시부고연등방면분석실습효과적영향인소。결과고핵지표체계신도위0.50,구분도위0.15,난도위0.85;병사채집、체격검사、입원기록、병례제문적거항목α계수위0.38、0.26、0.47、0.53,구분도위0.18、0.17、0.27、0.37,난도위0.87、0.89、0.79、0.78。녀생고핵총분、병사채집화체격검사득분고우남생(P<0.05);불동의원실습적학생성적차이무통계학의의(P>0.05);미고연학생총분고우고연학생,차이유통계학의의(P<0.05)。결론본차고핵체계합리,결과가고,학생림상기능장악교호,단잉수규범병례제문고핵;실습의원인소대실습효과영향불대,학생성별、시부고연량인소영향실습효과。
Objective To evaluate the assessment index system of internal medicine, and to analyze the factors of practical effects on internal medicine. Methods The assessment index system of clinical skills was developed by expert group based on the clinical syllabus and objectives. Internal medicine index system was divided into four items such as history-taking, physical examination, hos-pital records and case questions. 49 five-year clinical interns who took internal medicine exams were researched. Reliability, validity, discrimination, difficulty were used to analyze the quality of assess-ment index system. Gender, teaching hospital and the preparation of postgraduate examination were used to explore the influencing factors of practical effects with independent t-test and Wilcoxon signed rank tests. Results The reliability, discrimination, difficulty of the assessment index system were 0.50, 0.15 and 0.85, respectively. The removing item coefficient of history collection, physical ex-amination, hospital records, case questions were 0.38, 0.26, 0.47 and 0.53, separately, and the discrimination were 0.18, 0.17,0.27 and 0.37, separately, and the difficulty were 0.87, 0.89, 0.79, and 0.78, respectively. The scores of assessment index system of girls were higher than those of the boys(P<0.05). Moreover, the girls scored higher in history collection and physical examination, compared with the boys(P<0.05). The discrepancy scores were not statistically significant among teaching hospitals (P>0.05). The students who prepared the postgraduate examination scored lower than the others(P<0.05). Conclusions The assessment index system of internal medicine is reason-able and reliable, but the assessment of case questions still needs to be standardized. Teaching hospi-tals have little effect on internship while gender and the preparation for postgraduate examination influence practice effects in internal medicine.