Mini-CEX模拟教学联合DOPS评估演练在重症医学住院医师规范化培训中的应用

  目的  探讨迷你临床演练评量(Mini-CEX)模拟教学联合操作技能直接观察法(DPOS)评估演练在重症医学住院医师规范化培训中的价值。  方法  选择2019年6—12月在蚌埠医学院第一附属医院重症医学科轮转的40例住院医师规范化培训学员，入科后按随机数字法平均分入传统带教组(20例)和Mini-CEX联合DOPS教学组(MD教学组，20例)，首先比较各组入科和出科时的理论成绩、技能操作成绩和病历书写质量是否有提高，再继续比较2组之间在出科时的学员成绩差异，最后对学员的教学满意度进行评价。  结果  经过传统教学培训后的学员出科时理论成绩和病历书写方面相较入科时有一定提升(均P < 0.05)，而技能操作方面未见明显提升(P=0.166)；经过Mini-CEX联合DOPS教学的学员出科时理论成绩、技能操作和病历书写方面相较入科时均有提升(均P < 0.05)。传统带教组和MD教学组比较，出科时2组之间的理论成绩和专业技能差异均有统计学意义(均P < 0.05)。2组学员对带教的满意度比较差异有统计学意义(P < 0.05)。  结论  在重症医学住院医师规范化培训中采用Mini-CEX模拟教学联合DOPS评估演练可以更好地提升学员的重症临床理论和操作技能，并且增加了学员对带教的满意度。 

The application of Mini-CEX simulation teaching combined with DOPS evaluation exercise in the standardized training of critical medical residents

Objective To explore the role of mini clinical evaluation exercise(Mini-CEX)simulation teaching combined with direct observation of operating skills(DOPS)evaluation exercise in the standardized training of critical medical residents.Methods From June 2019 to December 2019,the students undergoing standardized training in the Intensive Care Unit of the First Affiliated Hospital of Bengbu Medical College were divided into the traditional teaching group and the Mini-CEX combined DOPS teaching group(MD teaching group).First of all,the theoretical scores,skill operation scores and medical record writing quality of each group were compare those on admission.Then,the differences of students’scores between the two groups were compared on graduation.Finally,the satisfaction of the student on teaching was evaluated.Results After the traditional teaching and training,the theoretical scores and medical record writing of the students were improved to a certain extent(all P<0.05),but the skills of operation were not significantly improved(P=0.166);After Mini-CEX combined with DOPS teaching,the theoretical scores,skill operation of the students were all improved when compared with those at the beginning of the training(all P<0.05).There were statistically significant differences in theoretical scores and skill operation scores between the traditional teaching group and the MD teaching group after training(all P<0.05).There was significant difference between the two groups in the satisfaction of teaching(P<0.05).Conclusion Mini-CEX simulation teaching combined with DOPS evaluation exercise in the standardized training of residents in intensive care unit can significantly improve the clinical theory and operation skills of the students,and increase the satisfaction of the students on the teaching.