伍冀湘　刘跃新　赵景武等

[摘要] 目的 分析在五站式考核中增加实际操作考核的可行性与提高教学效果的有效性。 方法 将我院2006级7年制医学生23人，分为甲乙两组，按照教学大纲进行外科临床实习，完成理论考试和五站式考核，甲组增加实际操作考核，均参加临床技能大赛。两组医学生的理论考试、五站式考核和临床技能竞赛成绩进行两独立样本t检验，设α=0.05。甲组实际操作考核和临床技能竞赛成绩进行相关样本t检验，设α=0.05。 结果 甲组在五站式考核时进行实际操作考核，考核过程顺利完成。甲乙两组医学生的理论考试、五站式考核成绩差异无统计学意义（P>0.05），临床技能竞赛成绩差异有统计学意义（P=0.001）。甲组实际操作考核和临床技能竞赛成绩差异无统计学意义（P>0.05）。 结论 在五站式考核时可以顺利进行实际操作考核，构成“5+X”模式。通过实际操作考核，可以有效地促进医学生掌握实际操作。

[关键词] 外科学；临床多站式考试；临床技能

[中图分类号] R4 [文献标识码] B [文章编号] 1673-9701（2015）11-0135-04

[Abstract] Objective To assess of feasibility and effectiveness about clinic skill test in the five clinical examination. Methods In our hospital， 23 medical students of 2006 grade seven-year systerm were divided into group A and group B. After clinical practice， the theory test and five clinical examination were completed in both groups， and group A underwent clinical skills competition， the results were taken for two independent samples t test， set α=0.05. Group A was taken the practical examination and clinical skills competition， results were taken for two related samples t test， set α=0.05. Results Group A had successful completion in practical assessment and five clinical examination. The results of theory test and five clinical examination had no significant difference in two groups （P>0.05）， and clinical skills competition results had significantly difference in two groups（P=0.001）. In group A， practical assessment and clinical skills competition results had no significantly difference（P>0.05）. Conclusion The five clinical examination and practical examination is applicable， which constitute "5+X" pattern. Through the practical examination， can promote the clinic skill of medical students.

[Key words] Surgery； Multistation clinical examination； Clinic skill

我院外科教研室自2008年始采用五站式考核方法对在临床实习阶段的临床医学专业5年制和7年制的医学生进行考核。采用的模式为：患者问诊、体格检查、提问辅助检查、病历书写和口试的流程[1]。但在带教教师的教学实践和考核过程中发现：该模式在外科、内科、妇产科和儿科相同，尚未能体现医学生在外科学习中实践性强的特点，在考核流程中存在外科学实践考核的盲点，导致在部分学生中出现重理论、轻实际操作的现象。因此……