持续质量改进应用于住院医师临床能力考评

目的探讨持续质量改进对提高住院医师临床能力考评效能的具体应用与收效。方法采用计划-实施-检查-处理（PDCA）循环应用的持续质量改进方法，改进住院医师临床能力考评效能。结果通过调查问卷、教学联席会等发现影响临床能力考评的主要问题包括临床实践机会少、考核形式较单一、评分标准不一致、人文观念欠缺等；通过开放临床技能中心、细化考评标准、多元化考评模式的应用、强化人文医学等方法，提高临床能力考评的效度与信度；一系列改进措施实施后再通过问卷调查评估质量改进效果，总结并提出质量改进方案。结论持续质量改进能有效提高住院医师临床能力考评效能，是一种实用、有效的方法，值得推广应用。

Application of Continuous Quality Improvement for Clinical Competence Assessment of Resident Physician

Objective To study the application of CQI in clinical competence assessment ot resident physi- cians, and its effects. Methods Circulation of PDCA （ plan - do - study - act） was implemented to improve the efficiency of clinical competence assessment. Results Questionnaire was implemented to evaluate the effect of CQI. The primary problems included less chance of clinical practice, single form of examination, scoring criteria inconsistency, deficiency of humanistic concept, etc. Many approaches were carried out to enhance the validity and reliability of examination of clinical competence, such as detailing assessment criteria, applying diversity assess- ments, strengthening humanistic concept. Conclusions CQI is an effective and practical way to improve the effi- ciency of clinical competence assessment in resident physicians.