优化肝胆外科标准化培训的mini-CEX和OSCE综合评估模型

IF 1.7 Q3 SURGERY

Surgery open science Pub Date : 2026-03-01 Epub Date: 2026-01-31 DOI:10.1016/j.sopen.2026.01.008

Hucheng Ma MD , Haozhen Ren MD , Xingyu Wu MD , Decai Yu MD

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引用次数: 0

摘要

背景中国住院医师培训的标准化需要健全的评估机制，但由于缺乏标准化的标准，存在着很大的差异。目前的工具，如OSCE（基于模拟的）和Mini-CEX（基于工作场所的）都有局限性：Mini-CEX不包括手术技能，而OSCE缺乏真实的临床背景。将它们结合起来提供了全面评估的潜力，但在肝胆外科手术中尚未得到充分研究。方法一项前瞻性队列研究将36名肝胆外科住院医师随机分为：实验组（n = 18）：每月进行Mini-CEX评估（通过9分制评估医学访谈、体格检查、临床判断、沟通、治疗计划、以患者为中心的护理和整体能力），随后进行最终的OSCE评估。对照组（n = 18）：每月进行传统的书面/程序评估，然后进行最终的欧安组织评估。欧安组织考试（满分100分）包括记录病史、体格检查、肝胆手术技能、病例分析和医患交流。组间比较采用学生t检验和卡方检验（SPSS 26.0, p <； 0.05显著）。结果两组患者基线特征无显著差异。实验组最终OSCE总分显著高于对照组（p < 0.05），体检和医患沟通均有显著改善。在病史记录、肝胆手术技巧或病例分析方面没有发现显著差异。实验组的满意度明显高于对照组（1/18比6/18）。学员们对Mini-CEX的实时反馈和能力映射非常重视。结论Mini-CEX与OSCE的整合为肝胆外科住院医师创建了一个有效的双模系统。与传统方法相比，它显著提高了整体临床能力（特别是体检和沟通）和学员满意度。这种组合方法提供了形成性反馈（Mini-CEX）和总结性验证（OSCE），建立了一个有前途的特定专业框架。建议未来进行多中心研究。

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An integrated mini-CEX and OSCE assessment model for optimizing standardized training in department of hepatobiliary surgery

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An integrated mini-CEX and OSCE assessment model for optimizing standardized training in department of hepatobiliary surgery

Background

Standardized residency training in China requires robust evaluation mechanisms, yet significant disparities exist due to lacking standardized criteria. Current tools like OSCE (simulation-based) and Mini-CEX (workplace-based) have limitations: Mini-CEX excludes surgical skills, while OSCE lacks authentic clinical context. Combining them offers holistic assessment potential but is understudied in hepatobiliary surgery.

Methods

A prospective cohort study randomized 36 hepatobiliary surgery residents into: Experimental group (n = 18): Monthly Mini-CEX assessments (evaluating medical interviewing, physical exam, clinical judgment, communication, treatment planning, patient-centered care, and overall competence via 9-point scale) followed by final OSCE. Control group (n = 18): Monthly traditional written/procedural assessments followed by final OSCE.

The OSCE (100-point max) comprised stations for history-taking, physical exam, hepatobiliary procedural skills, case analysis and doctor-patient communication. Intergroup comparisons used Student's t-tests and chi-square tests (SPSS 26.0, p < 0.05 significant).

Results

Baseline characteristics showed no significant differences between groups. The experimental group achieved significantly higher final OSCE total scores (p < 0.05), with notable improvements in physical examination and doctor-patient communication. No significant differences were found in history-taking, hepatobiliary procedural skills, or case analysis. Satisfaction was significantly higher in the experimental group (1/18 vs. 6/18 dissatisfied in controls). Trainees valued Mini-CEX's real-time feedback and competency mapping.

Conclusions

Integrating Mini-CEX and OSCE creates an effective dual-modality system for hepatobiliary surgery residents. It significantly enhances overall clinical competency (especially physical exam and communication) and trainee satisfaction compared to traditional methods. This combined approach provide both formative feedback (Mini-CEX) and summative validation (OSCE), establishing a promising specialty-specific framework. Future multi-center studies are recommended.

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来源期刊

Surgery open science Surgery

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

66 days