Chen Walter, Lai Ming-May, Li Tsai-Chung, Chen Paul J, Chan Cho-Yu, Lin Cheng-Chieh
School of Medicine, China Medical University, and Department of Pediatrics, China Medical University Beigang Hospital, Taichung 40402, Taiwan.
J Contin Educ Health Prof. 2011 Fall;31(4):225-30. doi: 10.1002/chp.20134.
The mini-clinical evaluation exercise (mini-CEX) is widely used for the evaluation of medical trainees' clinical competence. To our knowledge, no study has examined the effect of mini-CEX on the preceptors. Based on the principle of "to teach is to learn twice," we hypothesized that the act of precepting a mini-CEX would enhance preceptors' own learning and performance.
A 21-item questionnaire incorporating the 3 out of 4 levels of Kirkpatrick's model was completed by experienced mini-CEX preceptors. Data collected from the questionnaire included ratings of Kirkpatrick's level of "Reaction" (level 1) and "Behavior" (level 3) and the frequencies of relearning the clinical skills related to mini-CEX, which assessed Kirkpatrick's "Learning" (level 2).
A majority of the respondents either strongly agreed or agreed that precepting the mini-CEX both increased reflection on their own clinical practice and had a positive impact on their clinical skills. More than 80% of preceptors reported relearning one or more of the mini-CEX clinical skills. Experienced preceptors relearned the clinical skills more frequently than the less experienced preceptors. About one-third of respondents indicated that being a preceptor of mini-CEX increased both self-confidence and health care quality in their own clinical practice.
These findings provide preliminary evidence suggesting that participating as a preceptor in a mini-CEX has a positive impact on the preceptor's professional development. Further studies are needed, including analyzing mechanisms of mini-CEX on the clinical skills of preceptor, and assessing whether similar effects can be observed in other teaching hospitals in different cultural contexts.
迷你临床评估练习(mini-CEX)被广泛用于评估医学实习生的临床能力。据我们所知,尚无研究考察过mini-CEX对带教教师的影响。基于“教学相长”的原则,我们推测担任mini-CEX带教教师的行为会提升带教教师自身的学习和表现。
经验丰富的mini-CEX带教教师完成了一份包含柯克帕特里克模型4个层级中3个层级的21项问卷。从问卷中收集的数据包括柯克帕特里克“反应”层级(第1级)和“行为”层级(第3级)的评分,以及重新学习与mini-CEX相关临床技能的频率,后者评估柯克帕特里克的“学习”层级(第2级)。
大多数受访者要么强烈同意要么同意担任mini-CEX带教教师既增加了他们对自身临床实践的反思,也对他们的临床技能产生了积极影响。超过80%的带教教师报告重新学习了一项或多项mini-CEX临床技能。经验丰富的带教教师比经验不足的带教教师更频繁地重新学习临床技能。约三分之一的受访者表示担任mini-CEX带教教师提高了他们在自身临床实践中的自信心和医疗质量。
这些发现提供了初步证据,表明作为带教教师参与mini-CEX对带教教师的专业发展有积极影响。需要进一步开展研究,包括分析mini-CEX对带教教师临床技能的作用机制,以及评估在不同文化背景下的其他教学医院是否能观察到类似效果。