摘要
背景 医学教育模式的改变对重症医学的临床带教提出了更高的要求,为其临床实践搭建分层级的教学体系,并探索如何利用数据化的结果指导临床带教各个环节进行细化、改进.研究方法 所有轮转我院重症医学科（Intensive Care Unit,ICU）的人员,均需按不同的轮科时间分阶段完成《重症医学科技能学习规划表》1份,并各于入科后3天内、出科前1周内接受与此相关的测评,对考核成绩的均值±标准差、知识点的难度和区分度进行教育测量学分析.主要结果 为期8个月的研究（2014年5-12月）中,实际在ICU轮科人员103人,共回收有效的入科测评 96份和出科测评 94份,其中入科考核成绩的均值±标准差为59.95±13.15（95%CI 57.28-62.21）,出科考核为59.79±14.55（95%CI 56.82-62.75）,P=0.936,两者无统计学差异;而轮科时间≥2个月的16位轮科人员成绩的亚组分析发现,入科测评的均值±标准差为69.12±9.44（95%CI 63.47-73.65）,而出科测评为75.63±11.49（95%CI 69.42-82.33）,P=0.017,比值比（Odds Ratio,OR）4.664.同时可实现每条题目的难度、区分度的测算.结论 ICU的临床教学效果可通过合理的层级教学来提升,并实现量化分析,测算各个知识点的难度、区分度,为进一步调整优化提供了教育测量学参考.
Introduction Teaching in the intensive care unit（ICU） can be challenging as a core-learning environment is undergoingtremendous changes. We assessed educational measurement parameters to see how the effect may be improved. Methods All medical students rotatedin this academic general ICU during a 8-months period were invited to join an ICU core-skill training program, tested both before and after the rotation,results were entered into a prospectively collected quality control database, scores were calculated by Mean value± Standard deviation（Mean ± SD）,the Difficulty and Discrimination of test items were analyzed and quantified as educational measurement parameters.Results Over the 8-months period（May – December 2014）, a total of 103 students joined the program, 96 valid pre-rotation examination papers （59.95±13.15, [95% confidence interval{CI} 57.28-62.21]） whereas 94 post-rotation ones （59.79±14.55, 95% CI： 56.82-62.75） were entered into the database, no significantly improve wasshown overall the students （p=0.936）. However, the post-rotation test scores increased （69.12±9.44 to 75.63±11.49, p=0.017） among the subgroup ofwhom rotated in ICU ≥ 2 months, with an odds ratio （OR） of 4.664. The Difficulty and Discrimination of each test item were alsocalculated.Conclusions In the general ICU, students who with extended rotation period resulted in higher scores of educational measurementparameters, which is an option to analyze and quantify the effect of clinical teaching of critical care medicine.
出处
《中华临床医师杂志（电子版）》
CAS
2016年第4期276-277,共2页
Chinese Journal of Clinicians(Electronic Edition)
基金
2012年度中华医学会医学教育分会、中国高等教育学会医学教育专业委员会医学教育研究课题（项目编号：2012-LC-5）
关键词
量化分析
临床实习
提纲式教学
形成性评价
教育测量
quantitative analysis
clinical skills
program director
education
training
residency
