Liu Min, Huang Yu-Sheng, Liu Keh-Min
Department of Anatomy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2006 Oct;22(10):475-83. doi: 10.1016/S1607-551X(09)70341-9.
Medical students are assumed to be competent to provide basic patient care independently on graduation. However, there is a gap between what students are expected to learn and what they have actually learned. This may be due to the lack of clearly defined learning objectives, well-organized curriculum, and properly administered assessment. In an attempt to tackle this problem, we conducted a three-step study. Firstly, we identified the core clinical competencies required of medical graduates in Taiwan. Secondly, we incorporated these clinical competencies into a new medical curriculum. Finally, we identified the most appropriate assessment methods for each clinical competency. In 2004, a set of minimally required clinical competencies for medical undergraduates in Taiwan was developed, which included 92 clinical skills, four communication skills, and seven kinds of attitudes. In order to prepare 3rd and 4th year medical students at Kaohsiung Medical University (KMU) for later clinical work, the medical curriculum committee integrated the teaching and assessment of the core clinical skills identified previously into relevant organ-system blocks of the new curriculum. To identify appropriate assessment methods for each clinical skill, a structured questionnaire of assessment methods based on the Toolbox of Assessment Methods (Accreditation Council for Graduate Medical Education) and The Scottish Doctor (Scottish Deans' Medical Curriculum Group) was developed and distributed to 40 senior clinical faculty members at KMU. Simulations and Models, Standardized Patient Examination (SP), and Objective Structured Clinical Examination (OSCE) were suggested to be most suitable to assess two-thirds of the core clinical skills. These assessment methods are commonly used in American and European medical schools. We believe that the implementation of the new curriculum at KMU accompanied by the use of Simulations and Models, SP, OSCE, and other teaching and assessment methods will help 3rd and 4th year students to prepare better for clinical practice in clerkships.
医学生在毕业时被认为有能力独立提供基本的患者护理。然而，学生预期要学习的内容与他们实际学到的内容之间存在差距。这可能是由于缺乏明确界定的学习目标、组织良好的课程以及管理得当的评估。为了解决这个问题，我们进行了一项分三步的研究。首先，我们确定了台湾医学毕业生所需的核心临床能力。其次，我们将这些临床能力纳入新的医学课程。最后，我们为每种临床能力确定了最合适的评估方法。2004年，制定了一套台湾医学本科生的最低临床能力要求，其中包括92项临床技能、4项沟通技能和7种态度。为了让高雄医学大学（KMU）的三、四年级医学生为日后的临床工作做好准备，医学课程委员会将先前确定的核心临床技能的教学和评估整合到新课程的相关器官系统模块中。为了确定每种临床技能的合适评估方法，基于《研究生医学教育认证委员会评估方法工具箱》和《苏格兰医生》（苏格兰院长医学课程组）开发了一份评估方法结构化问卷，并分发给KMU的40名资深临床教员。模拟与模型、标准化患者检查（SP）和客观结构化临床考试（OSCE）被认为最适合评估三分之二的核心临床技能。这些评估方法在美国和欧洲的医学院校中普遍使用。我们相信，在KMU实施新课程并结合使用模拟与模型、SP、OSCE以及其他教学和评估方法，将有助于三、四年级学生更好地为临床实习中的临床实践做好准备。
