客观结构化临床考试在护理教育中的开展现状研究

本文介绍了客观结构临床考试的定义和研究现状,重点对该考试在护理中的运用模式进行综述,从护理教育的角度,分析这一考核方式与其他考试相比的优缺点及今后的发展方向。     

浅谈客观结构化临床考试的应用及展望

客明结构化临床考试(OSCE)是一种客观、有序的考试框架,已经广泛地应用于国内外医学教育的考试.本文提出了在某医院实行这一方案的初步设想.     

浅谈客观结构化临床考试(OSCE)的体会

客观结构化临床考试（OSCE）是一种客观的临床能力考试模式。我校今年首次在医学本科毕业生中进行。对标准化病人（SP）培训、考官、考场的准备工作、学生都有不同的要求。     

客观结构化临床考试在主治医师医患沟通能力评价中的应用

目的 运用OSCE方法,对主治医师医患沟通能力进行考核评价.方法 以81名晋升主治医师职称满3年的临床医师作为研究对象,基于OSCE考核方式进行考站设置和评价量表设计,做好评委和标准化病人家属的培训,通过告知完整性和沟通能力两个维度对考察对象的医患沟通能力进行评价.结果 考察对象在各考核内容之间的成绩具有差异性,询问是...     

客观结构化临床考试的结构效度和结构模型研究

采用多质多法分析和结构方程模型,对客观结构化临床考试的结构效度进行评估,验证其测评方法和能力维度的结构模型,探讨其评分导向的特点.结果表明,客观结构化临床考试的汇聚效度较好,而区分效度并不理想,该考试具有测评方法导向的特点     

浅谈客观结构化临床考核在儿科临床教学中的应用

随着医学教育的发展、医疗环境的变化及儿科的特殊性，儿科临床实践教学面临巨大挑战。客观结构化临床考核为儿科教学模式改革提供了一种新的思路，能在一定程度上解决医学生临床实践学习的困难，但是如何在教学实践中不断地补充和完善这一新的教学模式是今后儿科教学改革应注意的问题。     

结构化临床考试在口腔医学生临床实习考核中的应用价值

目的 探究在口腔医学生临床实习考核中应用结构化临床考试的价值。方法 随机抽取40名医学生纳入实验研究范围,其均于2019年1~12月于我院实习,采用等量数字随机方式分组,分别应用结构化临床考试(实验组,n=20)及常规笔试考试(对照组,n=20)方式开展考核,分析考核效果。结果 20名口腔医学生各站点测试成绩合格率均高于80.00%,最高成绩为第五站点(89.6±4.8)分,最低成绩为第六站点(79.6±5.8)分。实验组医学生考试满意程度显著高于对照组,差异显著(P<0.05)。结论 采用结构化临床考试方式对口腔医学生开展临床实习考核,有利于提升实习生实践技巧及理论把握能力,应用价值较高。     

客观结构化临床考试成绩与认知领域考试成绩关系的统计分析

针对传统方法考试内容随意性大,衡量医学生临床能力的局限和明显存在对考生能力测试的不全面性和评价方法主观性的问题,MR Harden于1975年首次提出客观结构化临床考试(Obective StructuredClinical Examination,简称OSCE)[1-2],OSCE减少评估者的数量,由标准化病人(Standardized Patient,简称SP)作为评估者,使评分的客观性大大增强.OSCE方法,避免了传统考试的偶然性和变异性,减少了主观性,增加了考试内容,评价遍及教育目标分类学所包括的认知、情感和精神运动三个领域,充分发挥了考试的功能.     

基于OSCE的高职护理教学评价模式构建与应用

目的:构建基于客观结构化临床考试(OSCE)的高职护理教学评价模式,探讨其在护理教学评价中应用的可行性及应用价值.方法:选取高职护理学院2018级专科护理专业的154名二年级护生,按教学模式将其分为观察组(78名)和对照组(76名),对照组采用传统的示教-练习-指导-考核教学模式,观察组采用基于OSCE的高职护理教...     

OSCE对临床医学生考试心理状况影响的情况分析

目的：观察客观结构化临床考试（OSCE）在评估临床医学本科毕业生临床能力中的应用及效果,并分析其对考生心理状况的影响,探讨其建立临床能力评价体系的可行性。方法：制定相关医学临床能力考核方案,选择2008级临床医学专业300名学生在预实习前,预实习结束OSCE与临床实习结束OSCE做心理健康症状自评量表SCL-90调查研究。结果：临床实习结束OSCE后,学生评分均明显低于预实习前与预实习结束OSCE,比较差异均有统计学意义（P〈0.05）。结论：OSCE可以客观、系统、准确评估临床医学生临床能力,但一定程度上造成考生抑郁、焦虑心理。     

Effects of basic clinical skills training on objective structured clinical examination performance

OBJECTIVES: The aim of curriculum reform in medical education is to improve students' clinical and communication skills. However, there are contradicting results regarding the effectiveness of such reforms. METHODS: A study of internal medicine students was carried out using a static group design. The experimental group consisted of 77 students participating in 7 sessions of communication training, 7 sessions of skills-laboratory training and 7 sessions of bedside-teaching, each lasting 1.5 hours. The control group of 66 students from the traditional curriculum participated in equally as many sessions but was offered only bedside teaching. Students' cognitive and practical skills performance was assessed using Multiple Choice Question (MCQ) testing and an objective structured clinical examination (OSCE), delivered by examiners blind to group membership. RESULTS: The experimental group performed significantly better on the OSCE than did the control group (P < 0.01), whereas the groups did not differ on the MCQ test (P < 0.15). This indicates that specific training in communication and basic clinical skills enabled students to perform better in an OSCE, whereas its effects on knowledge did not differ from those of the traditional curriculum. CONCLUSION: Curriculum reform promoting communication and basic clinical skills are effective and lead to an improved performance in history taking and physical examination skills.     

客观结构式临床测验在双语教学中的应用

目的将简化的客观结构式临床测验（Objective Structured Clinical Examination,OSCE）引入临床双语教学,研究其提高双语教学效率的作用,以探讨建立一种新的双语教学模式的可行性。方法将OSCE中几种临床常见疾病的病史采集、体格检查等相关内容译成双语,以培训过的临床医师扮演标准化病人（Standardized Patients,SP）,训练学生来进行双语的病史采集和体格检查,最后对学生在规定时间内独立完成的相应项目进行评估。结果经过OSCE方式训练过的学生,能较好地运用英语进行问诊及体查。结论客观结构式临床测验对提高双语教学的效率有一定作用。     

2种评价方法在护理本科生临床教学实习中的效果比较

目的比较2种不同评价方法在护理本科生临床教学实习中的应用效果。方法选择125名三年级护理本科生,在内、外科护理学课程2周的教学实习过程中,分别应用书写整体护理病历和撰写护理个案论文2种评价方法。教学实习结束后,采用自行设计的问卷进行调查。结果学生认为书写整体护理病历评价教学实习有利于提高整体护理临床思维的能力,撰写护理个案论文有利于培养学生的科研意识,提高其护理信息能力和掌握科研方法。结论 2种评价方法各有特色,应有机结合,为培养学生综合能力提供平台和机会。     

结构化教育治疗儿童孤独症的疗效

【目的】观察结构化教育治疗儿童孤独症的疗效,为临床治疗提供参考依据。【方法】对32例儿童孤独症患儿进行评估后,制定个别化教育计划。训练中应用结构化教育模式,将视觉线索应用到各个活动场所,强调作息时间和教学环境的结构化,强调工作组织的结构化。每周5 d,每天6 h,共训练6个月。用孤独症治疗评估量表(AutismTreatment Evaluation Checklist,ATEC)及C-PEP进行疗效评估。【结果】32例患儿孤独症儿童量表平均总分由训练前的(96.09±18.95)分下降到(54.91±14.10)分(P<0.001),量表中言语、社交、感知觉、行为四个分项目得分显著下降(P<0.001)。C-PEP评估功能发展平均分值由训练前(28.00±11.08)提高到(48.00±11.27),年龄当量提高(9.00±5.32)个月,扣除生理增长6个月,实际年龄当量增长(3.00±5.32)个月。【结论】结构化教育治疗对孤独症是一有效的训练方法。     

Scoring the objective structured clinical examination using a microcomputer

The objective structured clinical examination (OSCE) is being used increasingly to assess students' clinical competence in a variety of controlled settings. The OSCE consists of multiple stations composed of a variety of clinically relevant problems (e.g. examining simulated patients, diagnosing X-rays, etc.) Generally, three types of performance data are collected: answers to multiple choice or true/false questions, written short answers, and performance check-lists completed by observers. In most OSCEs these student performance measures are scored by hand. This is time-consuming, increases the probability of mistakes and reduces the amount of data available for analysis. This paper describes a method of computer scoring OSCEs with over 100 students using statistical and test-scoring software regularly used for multiple choice examinations. During the examination, students, markers and raters code answers and performance data directly on optical mark-sheets which are read into the computer using an optical mark reader. The resultant computer data can be efficiently scored and rescored, grouped into different types of subscales, weighted to reflect questions' relative importance, and easily printed in a variety of report formats.     

Techniques for measuring clinical competence: objective structured clinical examinations

The traditional clinical examination has been shown to have serious limitations in terms of its validity and reliability. The OSCE provides some answers to these limitations and has become very popular. Many variants on the original OSCE format now exist and much research has been done on various aspects of their use. Issues to be addressed relate to organization matters and to the quality of the assessment. This paper focuses particularly on the latter with respect to ways of ensuring content validity and achieving acceptable levels of reliability. A particular concern has been the demonstrable need for long examinations if high levels of reliability are to be achieved. Strategies for reducing the practical difficulties this raises are discussed. Standard setting methods for use with OSCEs are described.     

Psychometric characteristics of the objective structured clinical examination

The objective structured clinical examination (OSCE) is increasingly being used as a method of clinical assessment yet its measurement characteristics have not been well documented. Evidence is accumulating that many OSCEs may be too short to achieve reliable results. This paper reports detailed psychometric analyses of OSCEs which were administered as part of a well-established final-year examination. Generalizability theory guided investigation of test reliability. At the present test length the OSCE components showed low reliabilities relative to written components. Satisfactory reliabilities could potentially be achieved if test length was increased to approximately 6 hours, a time which would create significant logistic problems for most medical schools. Several strategies for dealing with this practical problem have been explored. Firstly, it was shown that more careful selection of stations based on their psychometric characteristics can significantly improve reliability. Secondly, where rater availability is a limiting factor to increasing test length, more can be gained by using one rater per station and having more stations than using two raters per station. Finally, OSCE scores can, with advantage, be combined with other test scores which are obtained by using less resource-intensive methods. By adopting such strategies, a reliable assessment of clinical competence could be obtained in about 4 hours of testing time which was equally divided between an OSCE constructed of practical and clinical stations and a written test.     

Reliability and validity of the objective structured clinical examination in paediatrics

The assessment of clinical competence has traditionally been carried out through standard evaluations such as multiple choice question and bedside oral examinations. The attributes which constitute clinical competence are multidimensional, and we have modified the objective structured clinical examination (OSCE) to measure these various competencies. We have evaluated the validity and reliability of the OSCE in a paediatric clinical clerkship. We divided the examination into the four components of competence (clinical skills, problem-solving, knowledge, and patient management) and evaluated the performance of 77 fourth-year medical students. The skill and content domains of the OSCE were carefully defined, agreed upon, sampled and reproduced. This qualitative evaluation of the examination was both adequate and appropriate. We achieved both acceptable interstation and intertask reliability. When correlated with concurrent methods of evaluation we found the OSCE to be an accurate measure of paediatric knowledge and patient management skills. The OSCE did not correlate, however, with traditional measures of clinical skills including history-taking and physical examination. Our OSCE, as outlined, offers an objective means of identifying weaknesses and strengths in specific areas of clinical competence and is therefore an important addition to the traditional tools of evaluation.     

医学学科竞赛培训方法用于课内教学的探索与实践

文章将医学学科竞赛培训中的案例中心教学法用于学生课内教学,并利用临床技能中心对学生进行全面、规范的l临床思维能力与操作技能培训和考核。结果显示,92．9％的学生认为案例中心教学法优于传统病例分析;参加技能培训学生各项操作考核平均成绩高于未参加培训者,差异有显著性。医学学科竞赛培训方法用于课内教学能有效提高学生的临床综合能力,同时这些教学法对教学组织者也提出了更高的要求。     

The objective structured clinical examination in undergraduate psychiatry

Inadequate attention has been given to verifying the psychometric attributes of the objective structured clinical examination (OSCE), yet its popularity has been increasing in recent years. Our 6 years' experience in Nigeria showed that OSCE is practicable in undergraduate psychiatry assessment and there is evidence over consecutive years that it has satisfactory reliability and criterion-based validity. The importance of students' feedback in assessing the quality of examination is reinforced, and subtle, less tangible elements which determine students' performance, such as social interactional mystique and some personality traits, are worthy of evaluative research.