Sim Joong Hiong, Abdul Aziz Yang Faridah, Mansor Azura, Vijayananthan Anushya, Foong Chan Choong, Vadivelu Jamuna
Medical Education & Research Development Unit, Faculty of Medicine, University of Malaya, Malaysia;
Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Malaysia.
Med Educ Online. 2015 Feb 18;20:26185. doi: 10.3402/meo.v20.26185. eCollection 2015.
The purpose of this study was to compare students' performance in the different clinical skills (CSs) assessed in the objective structured clinical examination.
Data for this study were obtained from final year medical students' exit examination (n=185). Retrospective analysis of data was conducted using SPSS. Means for the six CSs assessed across the 16 stations were computed and compared.
Means for history taking, physical examination, communication skills, clinical reasoning skills (CRSs), procedural skills (PSs), and professionalism were 6.25±1.29, 6.39±1.36, 6.34±0.98, 5.86±0.99, 6.59±1.08, and 6.28±1.02, respectively. Repeated measures ANOVA showed there was a significant difference in the means of the six CSs assessed [F(2.980, 548.332)=20.253, p<0.001]. Pairwise multiple comparisons revealed significant differences between the means of the eight pairs of CSs assessed, at p<0.05.
CRSs appeared to be the weakest while PSs were the strongest, among the six CSs assessed. Students' unsatisfactory performance in CRS needs to be addressed as CRS is one of the core competencies in medical education and a critical skill to be acquired by medical students before entering the workplace. Despite its challenges, students must learn the skills of clinical reasoning, while clinical teachers should facilitate the clinical reasoning process and guide students' clinical reasoning development.
本研究的目的是比较学生在客观结构化临床考试中评估的不同临床技能（CSs）方面的表现。
本研究的数据来自医学专业最后一年学生的结业考试（n = 185）。使用SPSS对数据进行回顾性分析。计算并比较了16个站点评估的六种临床技能的平均值。
病史采集、体格检查、沟通技能、临床推理技能（CRSs）、操作技能（PSs）和职业素养的平均值分别为6.25±1.29、6.39±1.36、6.34±0.98、5.86±0.99、6.59±1.08和6.28±1.02。重复测量方差分析显示，所评估的六种临床技能的平均值存在显著差异[F(2.980, 548.332)=20.253, p<0.001]。两两多重比较显示，所评估的八对临床技能的平均值之间存在显著差异，p<0.05。
在所评估的六种临床技能中，临床推理技能似乎是最弱的，而操作技能是最强的。由于临床推理技能是医学教育的核心能力之一，也是医学生进入工作岗位之前需要掌握的关键技能，因此学生在临床推理技能方面的不理想表现需要得到解决。尽管存在挑战，学生必须学习临床推理技能，而临床教师应促进临床推理过程并指导学生临床推理能力的发展。
