目的 探讨形成性评价结合医视考试系统在耳鼻咽喉科住院医师规范化培训(以下简称住培)中的应用效果。方法 本研究采用自身前后对照方法。选取2019年7月至11月在大连医科大学附属第二医院耳鼻咽喉科专业基地(以下简称基地)接受住培的17名学员为研究对象。其中,2017年进入基地的10名学员设为A组; 2018年进入基地的7名学员设为B组。采用形成性评价结合医视考试系统进行培训和日常考核,记录学员14次日常考核的成绩,通过考核成绩、问卷调查结果评价培训效果。采用重复测量方差分析,研究不同培训次数和分组对日常考核成绩的影响。结果 A组和B组学员在日常考核成绩[(133.49±13.81)分比(131.89±12.26)分]方面的差异无统计学意义(P>0.05);培训次数(不考虑其他影响因素干扰时)对日常考核成绩影响的差异具有统计学意义(P<0.01);随着培训次数增加,分组对考核成绩的影响无统计学意义(P>0.05);经过3次培训后学员成绩迅速提升,后续成绩处于平稳趋势。问卷调查结果显示,17名学员均对耳鼻咽喉科专业知识掌握、病历书写能力提高、通过住培和其他考试、同带教教师及时沟通方面的提高表示非常满意,且17名学员对带教教师和培训均非常满意。结论 形成性评价结合医视考试系统有助于提高耳鼻咽喉科住培学员的考核成绩,提升了培训质量,且适用于不同培训阶段的住培学员,得到了住培学员的认可。

Objective To explore the application effect of formative assessment combined with medical vision world examination system in improving the quality of standardized residents training. Methods Self-control method was used in this study. Totally 17 residents who received standardized training in otolaryngology training base institute in the Second Affiliated Hospital of Dalian Medical University from July to November 2019 were selected as the research objects, including 10 trainees who started training in 2017 (group A) and 7 trainees who started training in 2018 (group B). The formative assessment combined with medical vision world examination system was used to strengthen the training and daily assessment every week. A total of 14 rounds of assessments were conducted. The training effect was evaluated by examination results and questionnaire survey. Repeated measurement ANOVA was used to study the influence of different training times and groups on daily examination results. Results There was no statistically significant difference in the average score of group A(133.49±13.81) and group B (131.89 ± 12.26) (P>0.05); There was statistically significant difference in the overall assessment results of different training times when other factors are not considered (P<0.01); With the increase of training times, the influence of groups on assessment results was not statistically significant (P>0.05); After three training, the results improved significantly and gradually stabilized. The results of satisfaction survey showed that all 17 students were very satisfied with following issues as the mastery of otolaryngology knowledge, the improvement of medical record documentation, completion of residential training, pass of examinations, skill of communication with their supervisors, and 17 students were very satisfied with the teaching and teachers. Conclusions Formative evaluation combined with medical vision world examination system is helpful to improve the assessment results of otolaryngology resident trainees and optimize the outcomes of training, it is suitable for trainees at different training stages, so it is well acknowledge by trainees at different stages.