客觀結構式教學測驗評量於放射技術學之應用：以臨床超音波技術教學訓練為例

Objective Structured Clinical Examination (OSCE) in Radiological Technology: An Assessment of the Performance in Diagnostic Ultrasound Technology

耿家鈺(Chia-Yu Keng) ； 江志明(Chih-Ming Chiang) ； 藍顥章(Howard Haw-Chang Lan) ； 吳貞芳(Chen-Fabg Wu) ； 吳金蘭(Chin-Lan Wu) ； 趙祖玫(Tsu-Mei Chao) ； 蔡志文(Chih-Wen Tsai) ； 陳啟昌(Clayton Chi-Chang Chen) ； 林政勳(Cheng-Hsun Lin)

《中華放射線技術學雜誌》 35卷2期 (2011/06) Pp. 91-98

https://doi.org/10.30045/CJRT.201106.0004

摘要

客觀性結構式臨床技能測驗（objective structured clinical examination；簡稱OSCE）教學課程已是當今世界各國醫學院與教學醫院之醫學教育主流測驗工具。醫事放射學生之醫療技術操作及實際醫療作業態度，常無法以傳統筆試方式來評量學習成效，OSCE將是一項適合測驗方法。但目前國內缺乏相關經驗及參考文獻。我們選擇超音診斷技術為主題，以醫事放射實習學生為對象，安排三週OSCE教學課程，於課程之第一、三週，分別安排前期及後期測驗，以客觀的評估學生的處理操作技巧與態度反應。於測驗中採立即回饋的教學方法，提高學生的學習成效。並於測驗後招開檢討會議，以雙向回饋方式提昇老師之教學技巧與教學品質。我們總共對64位醫事放射實習學生實施OSCE課程。結果有九成實習學生對於我們設計的臨床能力評估項目，均能達到「一般水準」以上，約一半實習學生更能進步到「良好」及「優異」程度。滿意度調查顯示，無論於課程、評核教師及學員受測心得等方面，實習學生對認為「好」與「非常好」的百分率均佔90%以上，顯示實習學生對OSCE教學課程有高度的認同。由研究各項測驗結果分析可看出，實習學生對於儀器之特殊或較新的功能、解剖或器官及其病灶的掃描技術、以及病灶之解剖部位等較不熟悉，需要更長時間超音波掃描練習，同時也要加強核心課程之教導，而學校也要加強要求學生對解剖的教育與認識。此外研究也發現，OSCE之前期測驗對實習學生確實有前導作用，可改善往後學習，提升後期測驗成績。超音波診斷技術之OSCE之教學課程及測驗，是適合目前醫事放射學生之超音波診斷實習教學與評核，而OSCE前期測驗是必要且有效的。

關鍵字

客觀性結構式臨床技能測驗 ； 放射技術 ； 超音波

並列摘要

Objective structured clinical examination (OSCE) teaching curriculum is nowadays the mainstream method for evaluating medical practice objectively in medical schools and teaching hospitals. The goals of this study were to assess the feasibility of OSCE in diagnostic US technology. From July 2008 to June 2010, 64 radiological technology students assigned to the department of radiology of Taichung Veterans General Hospital, Taiwan, for internship were enrolled. The diagnostic US technology teaching curriculum for all students was totally 3 weeks. In 14 students (group A), only summative OSCE were performed. Formative and summative OSCE for 50 students (group B) were carried out in the first and last weeks of the course respectively. Wilcoxon signed-rank test was used to assess the difference between formative and summative OSCE in group B students, and the difference of summative OSCE between group A and group B. In group B students, the summative OSCE scores were upgrading in most students, 84.8%, 87.4%, 89.8%, and 94.7% were in part Ⅰ, part Ⅱ, part Ⅲ, and part Ⅵ respectively. The difference of mean scores between formative and summative OSCE for four examination parts were statistically significant (p＜0.0001). The mean summative OSCE scores of group A versus group B were 3.01 vs 3.61 (part Ⅰ), 3.10 vs 3.88 (part Ⅱ), 2.77 vs 3.57 (part Ⅲ), and 2.88 vs 4.07 (part Ⅵ). Significant differences were found at p value less than 0.005. In conclusion, the OSCE is applicable in diagnostic US technology. The formative OSCE not only shows to students what to learn but also provides information for tutors how to teach.

並列關鍵字

OSCE ； ultrasound ； radiology