Stillman P L, Wang Y, Ouyang Q, Zhang S, Yang Y, Sawyer W D
Medical College of Pennsylvania, Allegheny University, Philadelphia, USA.
Med Educ. 1997 Jan;31(1):33-40. doi: 10.1111/j.1365-2923.1997.tb00040.x.
The objective of this study was to develop a competency-based clinical skills teaching and assessment programme in China utilizing modern teaching techniques. Medical teachers from three schools agreed on items for inclusion in the complete physical examination of an asymptomatic adult, an outline for an adult and paediatric history, and important interviewing skills. Lesson plans, performance checklists, and written and videotape training materials were developed. Standardized patients were trained at one school to assist with the teaching at that school and with the assessment at all three schools. A national, a provincial, and a local medical school in China were used. Before beginning the new curriculum for students in their first year of clinical training, baseline data were collected on skills of students at various levels of training in the previous curriculum at all three schools. Although in the previous curriculum there was some improvement in clinical skills among advanced compared to more junior students, performance was lower than expected by staff. One year after implementation of the new curriculum, students were evaluated. These students significantly outperformed their counterparts as well as the more senior level students tested the previous year. This project has established a competency-based teaching and assessment programme in China that allows for rapid improvement in the clinical skills of students. Within a short time, a sophisticated group of medical educators has been formed, who now function as consultants to other educators in their own country. Many aspects of this programme are being adapted throughout China and are applicable to medical schools throughout the world.
本研究的目的是利用现代教学技术在中国开发一个基于能力的临床技能教学与评估项目。来自三所学校的医学教师就无症状成年人全面体格检查的纳入项目、成人及儿科病史大纲以及重要的问诊技巧达成了一致。制定了教案、表现清单以及书面和录像培训材料。在一所学校培训标准化病人，以协助该校的教学以及所有三所学校的评估工作。采用了中国的一所全国性医学院、一所省级医学院和一所地方医学院。在开始为临床培训一年级学生开设新课程之前，收集了所有三所学校在前一课程中不同培训水平学生技能的基线数据。尽管在前一课程中，高年级学生相比低年级学生在临床技能方面有一定提高，但表现低于教师预期。新课程实施一年后，对学生进行了评估。这些学生的表现明显优于他们的同龄人以及前一年测试的高年级学生。该项目在中国建立了一个基于能力的教学与评估项目，使学生的临床技能得以快速提高。在短时间内，形成了一批经验丰富的医学教育工作者，他们现在担任本国其他教育工作者的顾问。该项目的许多方面正在中国各地推广应用，并且适用于世界各地的医学院校。
