标准化病人在全科学员临床能力强化培训中的应用效果评价

目的 探讨标准化病人在全科学员临床能力强化培训中的应用.方法 以上海中山医院的53名全科学员作为研究对象,随机分为干预组和对照组.对照组进行常规临床轮转,干预组尚接受由标准化病人介导的临床能力强化培训课程.3个月后,通过标准化病人站点的考核比较两组学员的临床能力.结果 干预前两组的基线状况比较差异无统计学意义（均P＞0.05）.干预后干预组的问诊、体检、医患沟通能力、综合接诊技能和病历书写、病例分析成绩均较干预前有显著提高（均P＜0.01）,其中医患沟通能力分数最高,为（82±10）分;对照组的问诊、体检、综合接诊技能和病历书写成绩也较3个月前有显著提高（均P＜0.01）,但医患沟通能力与之前相比,差异无统计学意义（P＞0.05）.干预后干预组的医患沟通、综合接诊技能、病例分析、问诊及病历书写成绩显著高于对照组（均P＜0.01或＜0.05）,但体检成绩两组差异无统计学意义（P＞0.05）.结论 在临床能力强化培训中采用标准化病人,能显著提高学员的医患沟通能力和综合接诊技能。

Application of standardized patients in intensive training of clinical skills for general practice trainees and its effectiveness

Objective To explore application of standardized patients (SPs) in intensive training of clinical competency for general practice trainees. Methods Fifty-three general practice trainees in Shanghai Zhongshan Hospital were enrolled in the study, randomly assigned to intervention and control groups. Control group proceeded in routine clinical rotation, while intervention group accepted intensive training course with SPs as trainers. Three months after intervention, clinical skills of the two groups were compared in a simulated medical environment. Results There was no statistically significant difference in their baseline characteristics between the two groups (P ＞0.05). Competency in history taking, physical examinations,communication with patients, comprehensive consultation, medical record writing as well as case-analysis,improved significantly in intervention group after intervention, as compared to those before it ( P ＜ 0. 01 ),with the highest score of communication skill of 82 ± 10. Although competency of history taking, physical examinations, comprehensive consultation, medical record writing also improved significantly three months later in control group as compared to their baselines (P ＜ 0. 01 ), while no statistically significant difference in their communication skills was found ( P ＞ 0. 05 ). Scores of skills in physician-patient communication,comprehensive consultation as well as medical record analysis were significantly higher in intervention group than those in control one after intervention ( P ＜ 0. 01 ), but no significant difference in physical examinations was found between the two groups ( P ＞ 0. 05 ). Conclusions Application of SP in intensive training course for clinical competency can remarkably improve their competency in interpersonal communication and comprehensive consultation for general practice trainees.