急诊外科教育中基于工作场所的评估提高住院医师临床核心能力。

IF 2.1
Journal of surgical education Pub Date : 2025-10-01 Epub Date: 2025-08-08 DOI:10.1016/j.jsurg.2025.103644
Wuchao Liu, Jie Ding, Xinhui Zhang, Xueqian Ma, Junchi Yang, Panyu Zhou, Xiaojun Shen
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引用次数: 0

摘要

目的:虽然对基于工作场所的评估(WPBA)方法进行了大量研究,但其在外科教育中的应用仍未得到充分探讨。本研究在急诊普外科住院医师标准化培训中实施WPBA,目的是评估其在提高临床核心能力方面的效果。设计:本前瞻性研究采用多模式评估框架,结合WPBA工具,即迷你临床评估练习(Mini-CEX)、直接观察实用技能(DOPS)、主观、客观、评估和计划(SOAP)、评估记录和多源反馈(MSF);并采用了能力评估指标。对实验组和对照组的核心能力得分和离职评估绩效进行对比分析。数据分析采用卡方检验或费雪精确检验。单位:海军医科大学第一附属医院,位于中国上海。对象:招募2024年1 - 3月在海军医科大学第一附属医院接受标准化EGS培训的住院医师63名。这些受训者按月随机化原则分为实验组和对照组。结果:基线特征在性别、训练等级、学历、标准化训练来源、标准化训练基地等组间差异无统计学意义(p > 0.05)。实验组在所有胜任力领域均表现出显著的训练后改善(p  0.05)。实验组的理论知识和医学文献得分略高于对照组(p > 0.05),而临床技能评估得分具有统计学上的显著优势(p )。结论:实施WPBA可有效提高EGS住院医师的临床核心能力,优化规范化培训结果,具有外科教育教学创新的价值1。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Workplace-Based Assessment in Emergency Surgical Education Improves the Clinical Core Competency of Residents.

Objective: While numerous studies exist on Workplace-Based Assessment (WPBA) methodologies, their application in surgical education remains underexplored. This study implemented WPBA within Emergency General Surgery (EGS) residency standardized training, with the aim to evaluate its efficacy in enhancing clinical core competencies.

Design: For this prospective study, a multimodal assessment framework incorporating WPBA tools, namely, Mini-Clinical Evaluation Exercise (Mini-CEX), Directly Observed Practical Skills (DOPS), Subjective, Objective, Assessment, and Plan (SOAP), an assessment recording, and Multisource Feedback (MSF); and competency evaluation metrics were employed. Comparative analysis of core competency scores and exit assessment performance was conducted between experimental and control groups. Data were analyzed using the chi-squared test or Fisher's exact test.

Setting: The First Affiliated Hospital of Naval Medical University, located in Shanghai, China.

Participants: Sixty three residents undergoing standardized EGS training from January to March, 2024, at the First Affiliated Hospital of Naval Medical University, were recruited. These trainees were allocated into either experimental or control groups, using monthly randomization principles.

Results: Baseline characteristics showed no statistically significant intergroup differences in gender, training grade, educational background, standardized training source, or standardized training base (p > 0.05). The experimental group demonstrated significant post-training improvements across all competency domains (p < 0.05), whereas the control group exhibited marginal improvement (p > 0.05). While theoretical knowledge and medical documentation scores were marginally higher in the experimental group (p > 0.05), clinical skills assessment scores showed statistically significant superiority (p < 0.05).

Conclusion: WPBA implementation effectively enhances clinical core competencies in EGS residents, and optimizes standardized training outcomes, suggesting its value as a pedagogical innovation in surgical education.1.

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