住院医师规范化培训阶段考核的研究

目的探索建立住院医师规范化培训阶段考核的有效方法。方法以2010年完成辽宁省普通专科培训的181名住院医师为研究对象，设计普通专科培训阶段考核流程并予以实施。考核主要包括理论考试（基础知识、专业知识及公共知识）及客观结构化临床考试（objective struc—tured clinical examination，OSCE）。数据行t检验和方差分析，以P≤0．05为差异有统计学意义。结果考核总成绩按照理论成绩40．00％，OSCE成绩60．00％的比例进行评价，其中有2人未通过考核。参加考核的住院医师OSCE总成绩均值达到了及格标准，（66．58±5．50）分；标准化病人（standardizedpatient，SP）考试与计算机模拟病例考试（computer-based case simulations，ccs）成绩均值接近及格标准，临床技能操作成绩均值达到了良好水平。2所大学间附属医院住院医师的OSCE总成绩、sP及CCS考试成绩差异有统计学意义（t=3．818，P=O．000：t=5．581，P=O．000；t5．419，P=O．013）。5所附属医院住院医师的OSCE总成绩、SP及CCS考试成绩差异也有统计学意义。结论住院医师培训阶段考核正处于逐步完善之中，通过OSCE在考核中的广泛应用，有助于住院医师临床能力的培养。

Study and exploration of stage assessment of standardized resident training

Objective To explore and establish the effective model of assessment for residen- cy training. Methods Totally 181 residents completed general specialist stage of resident training of Liaoning province in 2010. Assessment process was designed and implemented for general specialist training stage, including theory exam （basic knowledge, professional knowledge and public knowledge） and objective structured clinical examination （OSCE） （standardized patient（SP）, computer-based case simulations（CCS） and clinical skills operation）. T test and variance analysis were used and P〈~O.05 stands for statistically significant difference. Results The total results consisted of two parts, theory examination resuhs （40.00%） and OSCE results （60.00%） and two students failed the examination. The mean score of OSCE was up to standard （66.58 ± 5.50）. The mean score of SP and CCS was close to standard. The mean score of clinical skills operation reached a good level. In terms of the OSCE, SP examination and CCS examination, the performance of residents from the two universities had sig- nificant difference （t=3.818, P=0.000; t=5.581, P=0.000; t=5.419, P=0.013） and the performance of residents from the five hospitals also had significant differences. Conclusions The assessment of standardized resident training is improving gradually. Through the widespread application of OSCE in the assessment; it could be helpful to the clinical training of residents.