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基于核心能力的客观结构化临床考试(OSCE)可以预测未来住院医师的表现。

A core competency-based objective structured clinical examination (OSCE) can predict future resident performance.

机构信息

Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA. USA.

出版信息

Acad Emerg Med. 2010 Oct;17 Suppl 2:S67-71. doi: 10.1111/j.1553-2712.2010.00894.x.

Abstract

OBJECTIVES

This study evaluated the ability of an objective structured clinical examination (OSCE) administered in the first month of residency to predict future resident performance in the Accreditation Council for Graduate Medical Education (ACGME) core competencies.

METHODS

Eighteen Postgraduate Year 1 (PGY-1) residents completed a five-station OSCE in the first month of postgraduate training. Performance was graded in each of the ACGME core competencies. At the end of 18 months of training, faculty evaluations of resident performance in the emergency department (ED) were used to calculate a cumulative clinical evaluation score for each core competency. The correlations between OSCE scores and clinical evaluation scores at 18 months were assessed on an overall level and in each core competency.

RESULTS

There was a statistically significant correlation between overall OSCE scores and overall clinical evaluation scores (R = 0.48, p < 0.05) and in the individual competencies of patient care (R = 0.49, p < 0.05), medical knowledge (R = 0.59, p < 0.05), and practice-based learning (R = 0.49, p < 0.05). No correlation was noted in the systems-based practice, interpersonal and communication skills, or professionalism competencies.

CONCLUSIONS

An early-residency OSCE has the ability to predict future postgraduate performance on a global level and in specific core competencies. Used appropriately, such information can be a valuable tool for program directors in monitoring residents' progress and providing more tailored guidance.

摘要

目的

本研究评估了住院医师培训第 1 个月进行的客观结构化临床考试(OSCE)预测未来住院医师在毕业后医学教育认证委员会(ACGME)核心能力方面表现的能力。

方法

18 名住院医师 1 年级(PGY-1)学员在住院医师培训的第 1 个月完成了 5 站 OSCE。在每项 ACGME 核心能力中对表现进行评分。在 18 个月的培训结束时,使用教师对住院医师在急诊科表现的评估来计算每个核心能力的累积临床评估分数。评估 OSCE 分数与 18 个月时临床评估分数之间的相关性,评估水平为整体水平和每个核心能力。

结果

整体 OSCE 分数与整体临床评估分数(R = 0.48,p < 0.05)和患者护理(R = 0.49,p < 0.05)、医学知识(R = 0.59,p < 0.05)和实践基础学习(R = 0.49,p < 0.05)等个别能力之间存在统计学显著相关性。在系统实践、人际和沟通技能或专业精神能力方面未观察到相关性。

结论

早期住院医师 OSCE 能够预测未来毕业后在全球水平和特定核心能力方面的表现。如果使用得当,此类信息可以成为项目主任监测住院医师进展和提供更具针对性指导的有价值工具。

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