以客觀結構臨床測驗評估畢業後一般醫學訓練之學員接受三個月專科相關選修－一般醫學內科訓練後之學習成效以及其所扮演之角色

The Learning Effectiveness of a Training Program in Internal Medicine in Postgraduate Year 1 and the Role of an Objective Structured Clinical Examination in Evaluating the Effectiveness

鄭修琦(Hsiu-Chi Cheng) ； 林威宏(Wei-Hung Lin) ； 謝棟漢(Tung-Han Hsieh) ； 陳柏齡(Po-Lin Chen) ； 張育誌(Yu-Tzu Chang) ； 蔡良敏(Liang-Miin Tsai)

《Journal of Medical Education》 13卷3期 (2009/09) Pp. 169-181

https://doi.org/10.6145/jme.200909_13(3).0003

摘要

背景與目的：利用客觀結構臨床測驗對接受畢業後「三個月專科相關選修－一般醫學內科訓練」的受訓學員進行臨床能力的評估，以瞭解學習成效及此測驗在成效評估所扮演的角色。對象與方法：對象為2007年11月至2008年10月接受內科三個月受訓的學員共52位。測驗分為五站，以自比式評量來評估學員於受訓前、後成績。結果：全體學員在受訓後之測驗皆比受訓前進步。經過三個月的訓練之後，在病史詢問、臨床雅理和人際溝通，大多數學員表現皆能達到優良與佳。非內科住院醫師經受訓後，病史詢問、腹部理學檢查有進步而與內科住院醫師相當。結論：評量結果顯示學員經一般醫學內科訓練具有學習成效，亦能提供給學員和課程負責人做為訓練安排和課程改進的參考。

關鍵字

畢業後一般醫學訓練，客觀結構臨床測驗，情境化評量 ； 學習成效

並列摘要

Background and aims: To evaluate the learning effectiveness of a training program in internal medicine for residents in postgraduate year 1 (PGY1) and the role of an objective structured clinical examination in the training program, we assessed the knowledge, skills and attitudes of PGY1 residents before and after training. Subjects and methods: A total of 52 PGY1 residents who rotated through the internal medicine training program participated in an objective structured clinical examination from November 2007 to October 2008. There were 5 stations in the examination, history taking, physical examination of the abdomen, clinical skills, clinical reasoning, and interpersonal and communication skills. Ipsative assessment was used before and after the training program. Results: All PGY1 residents showed progress in all 5 stations after the training program. After the training program, most residents (＞80%) showed excellent and good performance in history taking, clinical reasoning, and interpersonal and communication skills. A comparison of PGY1 residents in the department of internal medicine with residents in other departments showed similar levels of performance in history taking and physical examination of the abdomen after the internal medicine training program. Conclusions: Our data showed that PGY1 residents demonstrated performance progress after a PGY1internal medicine training program. The results of the objective structured clinical examination could be used as an ”assessment for learning” for PGY1 residents. It could also provide the information for the curriculum manager and teachers on preparation and and modification of the curriculum and teaching materials.

並列關鍵字

postgraduate year 1 PGY1 internal medicine training program ； objective structured clinical examination ； contextual assessment ； learning effectiveness

參考文獻

Rider EA,Nawotniak RH,Smith G(2007).A practical guide to teaching and assessing the ACGME core competencies.Marblehead:HCPro, Inc.

Harden RM,Stevenson M,Downie WW(1975).Assessment of clinical competence using objective structured examination.Br Med J.1,447-451.

Harden RM,Gleeson FA(1979).Assessment of clinical competence using an objective structured clinical xamination (OSCE).Med Educ.13,41-54.

McFaul PB,Taylor DJ,Howie PW(1993).The assessment of clinical competence in obstetrics and gynaecology in two medical schools by an objective structured clinical examination.Br J Obstet Gynaecol.100,842-846.

Tervo RC,Dimitrievich E,Trujillo AL(1997).The objective structured clinical examination (OSCE) in the clinical clerkship: an overview.S D J Med.50,153-156.