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中南大学湘雅医学院附属儿童医院(湖南省儿童医院)感染科,长沙 410002
姚婷新,Email:253200220@qq.com
收稿:2025-04-02,
纸质出版:2025-10-20
移动端阅览
张劲松, 谷芬, 于四景, 等. 儿童感染科规培教学动态能力评估体系的构建与应用实践[J]. 中华医学教育探索杂志, 2025, 24(10): 1342-1349.
Zhang Jinsong, Gu Fen, Yu Sijing, et al. Construction and practice of a dynamic competency assessment system for standardized training in the department of pediatric infection diseases[J]. Chinese journal of medical education research, 2025, 24(10): 1342-1349.
张劲松, 谷芬, 于四景, 等. 儿童感染科规培教学动态能力评估体系的构建与应用实践[J]. 中华医学教育探索杂志, 2025, 24(10): 1342-1349. DOI: 10.3760/cma.j.cn116021-20250402-02129.
Zhang Jinsong, Gu Fen, Yu Sijing, et al. Construction and practice of a dynamic competency assessment system for standardized training in the department of pediatric infection diseases[J]. Chinese journal of medical education research, 2025, 24(10): 1342-1349. DOI: 10.3760/cma.j.cn116021-20250402-02129.
目的
2
构建适用于儿童感染科住院医师规范化培训的动态能力评估体系,并验证其教学实践效果,以提升专科医师的核心胜任力。
方法
2
基于德尔菲法(Delphi)构建评估体系,通过两轮专家函询(
n
=20,权威系数Cr=0.889~0.895)确立5项一级指标、13项二级指标和38项三级指标,涵盖临床思维、操作技能、职业素养等维度。采用分层递进设计和动态反馈机制。选取60名规培医师随机分为观察组(动态评估体系)和对照组(传统评估),对比两组在短期教学效果(OSCE考核、Mini-CEX评分等)及长期临床能力(结业考核通过率、不良事件发生率等)上的差异。采用SPSS 24.0进行
t
检验、Mann-Whitney
U
检验及内部一致性检验(Cronbach’s
α
=0.89)。
结果
2
观察组学员在专科核心能力及临床实践效果方面均优于对照组。在专科核心能力方面,观察组学员病原学结果响应速度评分更高[(4.10±0.84) vs. (3.60±0.95),
P
=0.042],表明动态评估体系有效提升了规培医师根据病原学证据快速调整治疗方案的能力;感染防控规范执行率和诊断准确率也优于对照组,体现了该体系在规范临床操作和提升诊断水平方面的优势。在长期临床能力方面,观察组结业考核通过率显著提高,医疗不良事件发生率显著降低,进一步验证了动态评估体系对规培医师临床胜任力的持续促进作用。
结论
2
本研究构建的动态评估体系能有效提升儿童感染科规培医师的专科核心能力(如病原学响应、感染防控)及长期临床胜任力,为优化专科医师培养模式提供科学依据。
Objective
2
To construct a dynamic competency assessment system suitable for standardized training of resident physicians in the department of pediatric infectious diseases
verify its teaching practice effectiveness
and enhance the core competence of specialist physicians.
Methods
2
Based on the Delphi method
an evaluation system was constructed. Through two rounds of expert consultation (
n
=20
authority coefficient Cr=0.889-0.895)
5 primary indicators
13 secondary indicators
and 38 tertiary indicators were established
covering dimensions such as clinical thinking
operational skills
and professional ethics. The hierarchical and progressive design and dynamic feedback mechanism were adopted. Sixty residents were randomly divide into an observation group (dynamic evaluation system) and a control group (traditional evaluation). Differences between the two groups were compared in terms of short-term teac
hing effectiveness (e.g.
OSCE assessment and Mini CEX score) and long-term clinical competencies (e.g.
exit assessment pass rate and incidence of adverse events). SPSS 24.0 was used for
t
-test
Mann Whitney
U
test
and internal consistency test (Cronbach's alpha=0.89).
Results
2
The observation group outperformed the control group in core specialty competencies and clinical practice outcomes. In terms of core specialty competencies
the observation group had a higher response speed score for pathogen results [(4.10±0.84) vs. (3.60±0.95)
P
=0.042
]
. This indicates that the dynamic evaluation system effectively enhanced the ability of trained physicians to quickly adjust treatment plans based on pathogenic evidence. The implementation rate of infection prevention and control standards and diagnostic accuracy were also higher in the observation group compared to the control group
reflecting the advantages of this system in standardizing clinical operations and improving diagnostic levels. In terms of long-term clinical competencies
the observation group showed significantly increased exit assessment pass rate and significantly decreased incidence of medical adverse events
further verifying the continuous promotion effect of the dynamic evaluation system on the clinical competence of trained physicians.
Conclusions
2
The dynamic evaluation system constructed in this study can effectively enhance the core specialty competencies (e.g.
pathogen response and infection prevention and control) and long-term clinical competence of residents in the department of pediatric infectious diseases
providing scientific basis for optimizing the training models of specialist physicians.
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