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題 名 | Assessment of Clinical Competence of Medical Students Using the Objective Structured Clinical Examination: First 2 Years' Experience in Taipei Veterans General Hospital=以客觀結構性臨床測驗(OSCE)評估實習醫學生之臨床能力:臺北榮總前兩年經驗 |
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作 者 | 黃金洲; 陳祖裕; 巫春蓮; 程雅琳; 楊惠文; 黃加璋; 陳震寰; 黃志賢; 李發耀; 林幸榮; 陳肇文; | 書刊名 | Journal of the Chinese Medical Association |
卷 期 | 73:11 2010.11[民99.11] |
頁 次 | 頁589-595+CA104 |
分類號 | 410.3 |
關鍵詞 | 臨床能力; 評估; 客觀結構性臨床測驗; 標準化病人; Clinical competence; Evaluation; Objective structured clinical examination; Standardized patient; OSCE; |
語 文 | 英文(English) |
英文摘要 | Background: Competence-oriented education is currently the mainstream method of teaching clinical medical education. The objective structured clinical examination (OSCE) is a widely employed and accepted tool to measure the clinical competence of medical students. We describe the first 2 years’ experience of OSCE in Taipei Veterans General Hospital. Methods: At Taipei Veterans General Hospital, every 7th-year medical student has taken the OSCE since 2006. There were 15 stations in the first 2 years’ OSCEs. In years 1 and 2, 133 and 132 students were assessed by the OSCE, respectively. The content of the OSCE included internal medicine, surgery, pediatrics, obstetrics and gynecology, communication, and emergency training. All categories and results of examinees’ evaluation at each station were recorded inclusively and compared statistically. Results: The average scores of students from the 15 stations ranged from 47.7 ± 16.4 to 93.7 ± 8.5 in 2007. The score for communication skills was the lowest, whereas the score for Micro-Sim was the highest. Communication skills and electrocardiography interpretation were the 2 categories in which most of the students failed. A reliability analysis was conducted of the 2007 OSCE questions. The overall score and reliability (Cronbach’s reliability) was 0.641. The difference between the impacts on reliability after deleting a test item ranged from 0.59 to 0.65 for all stations. This meant that every station had a similar impact on reliability after being deleted. The squared multiple correlation, R2, of the reliability of each item was between 0.12 and 0.49, with chest X-ray interpretation being the lowest. The item–total correlation was between 0.10 and 0.41, with interactive case being the lowest. Conclusion: The OSCE is an effective method for assessing the clinical competence of medical students. The OSCE could be improved further by modifying the examination questions and promoting effective training for standardized patients and examiners. |
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