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中医药研究论丛
 221.24 以客观结构临床测验评估中医实习医学生中医实习之学习成效
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TJ TCM.22(1) : 255-264, 2019
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以客观结构临床测验评估中医实习医学生中医实习之学习成效
Use of An Objective Structured Clinical Exam (OSCE) for Evaluating the Learning Effectiveness in the Clinical Internship of Chinese Medical Students
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沈炫枢1,5 叶家舟2,5 陈建仲3,5 陈建霖4,5 柯建新1,5*
1 佛教慈济医疗财团法人花莲慈济医院中医部，花莲，台湾
2 佛教慈济医疗财团法人大林慈济医院中医部，嘉义，台湾
3 佛教慈济医疗财团法人台中慈济医院中医部，台中，台湾
4 佛教慈济医疗财团法人台北慈济医院中医部，台北，台湾
5 慈济大学学士後中医学系，花莲，台湾
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【摘要】
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背景：利用客观结构临床测验对中医实习医学生进行临床能力评估，了解实习的学习成效。
对象与方法：收案对象为2017 年6 月至2018 年5 月进行实习之中医医学生42 位。利用前後测分数差异来评估实习之学习成效。前後测皆为6 站。
结果：後测之总成绩有明显进步(366.7±39.6 VS 396.7±48.9)，以科别来说，中医妇科、中医内科、中医伤科後测成绩较前测成绩高(48.1±12.2 VS70.9±11.1, 50.9±18.1 VS 66.6±10.7, 45.6±18.7 VS 57.9±14.1)。然而，中医儿科後测成绩则明显退步(64.8±10.3 VS 51.8±10.5)。以面向来看，中医四诊与临床技能操作後测成绩显着进步。
结论：整体而言，经过一年实习後，中医实习医学生有不错的学习效果，但在病史询问方面仍有进步空间。此结果可供临床教师作为教学课程改进之叁考。
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【关键词】客观结构临床测验、中医、实习、学习成效
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Hsuan-Shu Shen1,5 Chia-Chou Yeh2,5 Jian-Jung Chen3,5 Chien-Lin Chen4,5 Chien-Hsin Ko1,5*
1Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical
Foundation, Hualien, Taiwan
2Department of Chinese Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical
Foundation, Chiayi, Taiwan
3Department of Chinese Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical
Foundation, Taichung, Taiwan
4Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical
Foundation, Taipei, Taiwan
5School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
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【Summary】
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Background: Based on the guidance in Chinese Medicine Clinical Skills Assessment Model and Clinical Teaching Practice Training Program, supported by the Ministry of Health and Welfare, we conducted the objective structured clinical examination (OSCE) to evaluate the learning effectiveness in the clinical internship for the fifth-year traditional Chinese medical (TCM) students.
Subjects and methods: A total of 42 Chinese medical students were enrolled in the study during July, 2017 to May, 2018. A pretest-posttest design was employed by this study. Participants were evaluated by the OSCE before and after the 1 year clinical practice with 6 assessments of clinical skills.
Results: The total score of posttest was significantly higher than that of pretest (366.7±39.6 VS 396.7±48.9, P<0.001). In term of subjects, the score at the posttest were higher than at the pretest, as the internal medicine of TCM (50.9±18.1 VS 66.6±10.7, P<0.0001), the gynecology of TCM (48.1±12.2 VS 70.9±11.1, P<0.0001) and the traumatology of TCM (45.6±18.7 VS 57.9±14.1, P=0.001). Notably, the score of the pediatrics of TCM at the posttest declined significantly than at the pretest (64.8±10.3 VS 51.8±10.5, P<0.0001). In terms of dimensions, the ability of the four diagnostic methods and the clinical skills of TCM improved among the TCM students after the clinical practice training.
Conclusions: To conclude, the TCM students made the progress in clinical competency after 1-year clinical internship, but there is a suggestion on improving the ability for the patient’s history taking. The result could provide the information for the clinical preceptors on the modification of teaching program.
Keywords：Objective Structured Clinical Examination, Traditional Chinese Medicine, Internship Program, Learning Effectiveness
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