目的 评价客观结构化临床考试(objective structured clinical examination,OSCE)在核医学专业住院医师规范化培训结业考核中的应用效果。方法 对2014年至2017年参加北京市核医学专业结业住院医师规范化培训考核的OSCE成绩进行分析,包括考试分数、通过率,以及试题难度、区分度、信度、效度。考站共计6站,包括放射性操作与防护、病例分析、问诊、图像采集与处理、医患沟通、报告书写。结果 2014年、2015年考生OSCE总成绩中位数(四分位数)分别为[89.20(86.68,92.30)]分、[88.38(83.33,90.80)]分,2016年、2017年考生OSCE总成绩分别为(86.52±3.33)分、(88.47±1.42)分,通过率均大于90%。2014年~2017年试题难度系数分别为0.87、0.87、0.87、0.88,内部一致性信度系数分别为0.88、0.72、0.55、0.32。历年各站考试的区分度位于0.49～0.92。2017年OSCE放射性操作与防护、病例分析、问诊考站的评分者信度较高,而图像采集与处理、医患沟通考站的评分者信度稍差。结论 OSCE能够真实模拟临床环境,有效评价核医学专业住院医师的临床综合技能,但还有待进一步优化考核方案来提高考核效果。
邸丽娟
,
廖栩鹤
,
王荣福
,
范岩
,
闫平
,
张建华
,
张春丽
,
张旭初
,
刘萌
,
崔永刚
,
赵光宇
,
孙宏伟
,
殷雷
,
陈雪祺
. 客观结构化临床考试在核医学专业住院医师临床技能考核应用中的效果评价[J]. 中华医学教育杂志, 2018
, 38(3)
: 430
-434
.
DOI: 10.3760/cma.j.issn.1673-677X.2018.03.026
Objective To evaluate the effectiveness of objective structured clinical examination (OSCE) for nuclear medicine residents in Beijing.Methods The OSCE score of residents participating the standardized training from 2014 to 2017 were analyzed, including score, passing rate, difficulty, discrimination, reliability, validity. The examination was composed of six stations including radioactivity operating and protection, case analysis, history acquisition, image acquisition and processing, doctor-patients communication, report writing.Results The median OSCE score of 2014 and 2015 was 89.20(86.68-92.30)、88.38(83.33-90.80) respectively. The mean OSCE score of 2016、2017 was (86.52±3.33), (88.47±1.42) respectively. The passing rate of each year was more than 90%. The difficulty was 0.87, 0.87, 0.87, 0.88,and the Cronbach α of reliability was 0.88, 0.72, 0.55, 0.32 respectively for OSCE from 2014 to 2017. The discrimination range was 0.49～0.92 for all stations. The raters reliability was good for stations including radioactivity operating and protection, case analysis, history acquisition and slightly bad for image acquisition and processing, doctor-patients communication in 2017.Conclusions OSCE can truly imitate clinical environment and evaluate the residents’s comprehensive clinical skills effectively, but the program should be further optimized to improve the application effects.
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