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目的探讨临床考官竞赛模式在临床师资培训和全科医师核心能力培养中的应用效果。方法两年来通过在上海市嘉定区中心医院开展临床考官竞赛与对规范化培训人员年度考核相结合的方式,培训临床师资和培训考核在院规培学员。以上海市住院医师规范化培训临床出科考核标准为蓝本,结合医师核心能力,组织设计考官竞赛内容,参照小型临床评价练习(mini-CEX)考核形式,制订竞赛流程、参赛规则;设计制订竞赛评分表和考官对学员的考评表;院内、外教学督导专家作为竞赛评委;科内预赛后选拔参赛考官,参赛考官选择真实病例编写考核案例,标准化病人为科内助理全科规培学员。被考核学员为在院规培全科医师满一年以上的学员,成绩作为本年度考核的技能考核成绩。竞赛结束时,专家组反馈竞赛中的优、缺点;参赛考官分享参赛感想;督导专家、参赛考官共同探讨改进考核案例的编写;分管教学的领导总结发言,提出进一步的改进措施和带教要求,并将竞赛模式、内容和经验推广应用到临床带教和考核过程中。结果规培学员院内外各类考试和执业考试合格率都明显提高,2015年规范化培训学员首次参加执业医生注册考试合格率均为100%。结论临床考官竞赛模式能够提高全科医师培养中教与学的效果,值得在全科医师培训中借鉴和推广。
Objective To explore the application effect of clinical exam contestants in clinical teacher training and general practitioner core competency. Methods In the past two years, the clinical examiners contest was conducted in Jiading District Central Hospital in Shanghai and the annual assessment of standardized trainers was conducted to train clinical teachers and trainees in the training and evaluation of hospital training. Based on the standard of clinical laboratory test for standardized residency training in Shanghai, combined with physician’s core competency, the contestants were organized to design the content of examiner contest and make reference to the mini-CEX assessment form to formulate contest procedures and entry rules. Table and examiners assessment of the trainees table; hospital, outside the teaching supervisor as a competition judge; Section within the pre-race selection of examiners, participating examiners choose the real case preparation assessment cases, the standardization of the patient for the Section within the discipline general training students. The trainees who have been appraised for the training of general practitioners in the hospital for more than one year, the result is taken as the result of the skill examination for the current year. At the end of the competition, the expert group fed back the advantages and disadvantages of the competition. The participating examiners shared their thoughts on the competition. The supervising experts and the examiners jointly discussed the preparation of the improved appraisal cases. The leaders in charge of the teaching summed up their speeches, proposed further improvement measures and teaching requests, And the competition mode, content and experience to promote the clinical teaching and assessment process. Results The qualification rate of all kinds of examinations and practice exams in and out of the institute was significantly improved. In 2015, the standardized rate of qualified trainees in attendance for practicing doctors for the first time was 100%. Conclusion The clinical examiner competition mode can improve the effect of teaching and learning in general practitioners training and is worth learning from general practitioners training.