以执业医师资格考试为导向构建Mini-CEX联合DOPS在急诊医学规培教学中的应用

目的 探究以执业医师资格考试为导向构建迷你临床演练评估（mini-clinical evaluation exercise，Mini-CEX）联合操作技能直接观察评估（direct observation of procedural skill，DOPS）在急诊医学规培教学中的应用效果。方法 以广西中医药大学附属瑞康医院急诊医学教学改革为分界线，将2020年9月前急诊科32名临床规培生纳为对照组，采用传统教学；将2020年9月后参加的32名临床规培生纳为观察组，采用以执业医师资格考试为导向构建Mini-CEX联合DOPS教学。比较两组Mini-CEX评分、DOPS评分、综合急救技能测评得分，执业医师资格考试通过率，以及综合教学质量。采用SPSS 25.00统计软件进行t检验和卡方检验。结果 培训后，观察组学员Mini-CEX、DOPS、综合急救技能测评各项评分均高于对照组（P<0.05）；两组执业医师资格考试理论和实践通过率比较，差异均无统计学意义，观察组总通过率高于对照组（P<0.05）；观察组综合教学质量各项评分均高于对照组（P<0.05）。结论 以执业医师资格考试为导向构建Mini-CEX联合DOPS有助于提高急诊规培生教学效果，有助于提升规培生综合技能、急诊专业技能，执业医师资格考试通过率较高，有利于提高规培生的岗位胜任能力，值得推荐。

Application of Mini-Clinical Evaluation Exercise combined with direct observation of procedural skills in standardized training of emergency medicine guided by professional physician qualification examination

Objective To investigate the application effect of Mini-Clinical Evaluation Exercise (Mini-CEX) combined with direct observation of procedural skills (DOPS) in standardized training of emergency medicine guided by professional physician qualification examination.Methods Based on the time of emergency medicine teaching reform in Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, 32 standardized training residents in Emergency Department before September 2020 were included as control group and were given traditional teaching, and 32 standardized training residents after September 2020 were included as observation group and were given Mini-CEX combined with DOPS teaching under the guidance of professional physician qualification examination. The two groups were compared in terms of Mini-CEX score, DOPS score, assessment score of comprehensive emergency skills, pass rate of professional physician qualification examination, and comprehensive teaching quality. SPSS 25.00 was used to perform the t-test and the chi-square test.Results Compared with the control group after training, the observation group had significantly higher scores of Mini-CEX, DOPS, and comprehensive emergency skill assessment (P<0.05). There were no significant differences between the two groups in the pass rates of theoretical and practical examinations in professional physician qualification examination, and the observation group had a significantly higher total pass rate than the control group (P<0.05). The observation group had significantly higher comprehensive teaching quality scores than the control group (P<0.05).Conclusion Mini-CEX combined with DOPS guided by professional physician qualification examination can help to improve the teaching effectiveness of standardized training residents in emergency, enhance their comprehensive skills and emergency professional skills, achieve a relatively high pass rate of professional physician qualification examination, and improve their post competency, and thus it holds promise for clinical application.