Application effect of objective structured clinical examination combined with standardized patients in standardized residenncy training clinical practice ability assessment / 中国中西医结合急救杂志

ABSTRACT

Objective To explore the application effect of objective structured clinical examination (OSCE) combined with standardized patients (SP) in the clinical practice assessment of standardized residenncy training. Methods A total of 97 clinical internal medical graduates from the First Affiliated Hospital of Xinjiang Medical University who participated in resident training from August 2016 to August 2017 were selected as the subjects, and they were divided into group A (48 cases) and group B (49 cases) according to the random number table. The standardized training course was 2 years, at the end of the first year of training, OSCE+SP model was used in group A for the examination, and group B was examined by traditional mode. After the 2nd year of training, the examination was again carried out, and the assessment models were exchanged between the A and B groups. The differences in various abilities and total scores of two groups were compared and analyzed statistically. Results In the first examination, the ability of collecting and analyzing medical history, physical examination ability, clinical skill operation ability, clinical thinking ability and total score of group A were significantly higher than those of group B (ability of collecting and analyzing medical history scores 24.9±2.9 vs. 22.9±2.4, physical exam ability scores 11.0±1.3 vs.10.0±1.3, clinical skill operation ability scores 21.3±2.0 vs.19.9±2.2, clinical thinking ability scores 72.0±7.2 vs. 66.8±13.8, total score72.9±4.7 vs. 68.0±3.1, all P < 0.05). In the second exam, the ability of collecting and analyzing medical history, physical exam ability, clinical skill operation ability, clinical thinking ability and total score of group A were significantly lower than those of group B (ability of collecting and analyzing medical history score 23.1±2.4 vs. 25.0±2.7, physical exam ability score 10.4±1.3 vs. 11.2±1.3, clinical skill operation ability score 20.1±2.4 vs. 21.4±2.2, clinical thinking ability score 69.1±6.4 vs. 72.2±8.0, total score 68.9±3.8 vs. 73.4±4.6, all P < 0.05). The results of variance analysis of two-stage interactive design showed that the new assessment model was the main factor that caused the statistical significant differences in medical students' examination results between the two groups (P < 0.05). Conclusion The new OSCE+SP model can more promote the improvement of medical students' achievements, benefit medical students from textbook theory entering into clinical practice, help resident doctors elevate their self comprehensive competency, and meet the requirements of medical development under the new national situation.