Mini-CEX, CbD, DOPS

: 1020913 : 123:30-14:20 : 20F

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: Mini-CEX CbD DOPS

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2003:()

2006:()

2007:

2009:

PGY()

2011:PGY

Paradigm of Education

MSF

OSCE

Mini-CEX

CbD

DOPS

()

Lecture

PBL

Bed side

OPD

1.

2.

3.

ACGME1999

1. ( patient care)

2. (medical knowledge)

3. (professionalism)

4. (communication and

interpersonal skills)

5. ( systems-based practice)

6. (practice-based learning and

improvement)

1. What you do

2. What you know

3. How You Interact

with Others

4. How You Act

5. How You Work

Within the System

6. How You Get Better

Competence Based Learning

:

:

:

: Mini-CEX CbD DOPS

:

(evaluation)

: (evaluation as measurement)

: (evaluation as determining congruence)

: (evaluation as professional judgement)

:

44786

Scriven

The goal of evaluation is not to prove but to

improve.

86

Mini-CEX, DOPS

OSCE

Case Based Discussion

Miller GE, Acad Med 1990

Dose

Shows how

Knows how

Knows

(MCQ)

(Leniency error)

(Severity error)

(Halo effect)

(First impression error)

(Friendship bias)

Substantial variations in ratings between faculty

members

Implications For Assessment Today

Do not rely on short tests

In order to make tests sufficiently reiable, a broad

sample must be used

Questions that take longer to answer produce in

general less reliable tests than questions that

allow for a quick answer

Do not rely on one method

No one single tool in panacea

Examination programme that consist of a variety

of carefully selected and combined methods

Workplace-based Assessment

Outcomes-based Assessment

:

:

:

: Mini-CEX CbD DOPS

:

Mini-CEX=; mini-PAT=;TAP=(); DOPS=: CBD=: SLI=()

:,mini-CEX.

2005 F2

Mini-

CEX

Mini-Pat,

TAB

DOPS CBD

/

For more knowledge-based aspects: MCQs

For problem-solving: many short cases-

based questions asking for essential decision

making

Observations in practice: kept short and

mildly structured & by different examiners

Mini-CEX

Assessment of attitude: frequent observation

of professional behavior in various settings

Discussion and feedback

:

( Multi-source fedback, MSF)

Mini clinic evaluation exercise (min-CEX)

Direct observation of procedure skills (DOPS)

Case based discission (CbD)

(https://pec.doh.gov.tw/Security/Login_pgy.aspx

99 4 12 0990066542 100 5 16 1000261810 100 10 4 1000264886 101 6 6 1010264674 102 2 5 1020268877

.

1360 2360 / 3 4 51 Mini-CEX CbD DOPS

/ PA (UGY) PGY

(Learning Passport) V V V

(MSF) V V V

V

(EBM) PICO/CAT V V V

(Mini-CEX) V V V

(OSCE) V V

(DOPS) V V V

(CbD) V V V

(Chart Round) V V

(MCQ) V V

:

:

:

: (Mini-CEX )

(CbD)

(DOPS)

:

Mini-CEX?

(ABMS)ACGME

mini-CEX

. (medical interviewing skills)

. (physical examination skills)

. (professionalism)

. (clinical judgment)

. (counseling skills)

. (organization/efficiency)

. (overall competence)

Mini-CEX

(15-20)

(5-10)

Chen W, et al. J Med Education

2005.

Mini-CEX

Mini-CEX

1-3 4-6 7-9

4 5 6 7 8

M5 M6 M7 R1 R2 R3 _____

__________

_____

____________________________________________

1.

1 2 3 4 5 6 7 8 9

2.

1 2 3 4 5 6 7 8 9

3.

1 2 3 4 5 6 7 8 9

4.

1 2 3 4 5 6 7 8 9

5.

1 2 3 4 5 6 7 8 9

6.

1 2 3 4 5 6 7 8 9

7.

1 2 3 4 5 6 7 8 9

____________

1 2 3 4 5 6 7 8 9

1 2 3 4 5 6 7 8 9

______________________________________________________________________

______________________________________________________________________

_____________________________________

_________________________

________________________

Mini-CEX

Mini-CEX

,

,

mini-CEX

mini-CEX

Immediate

5-10 minutes

Self-assessment

Recommendations

21%

10%

1%68%

Less specific

Only positive

No written

Specific Postiveand negative

Yeh JH,etal; J Med Education

2008;12:77-83

(CbD) Case-based Discussion

National Healthcare System (NHS)Healthcare Assessment and Training (HCAT)

Foundation Program (PGY Program)

clinical reasoning

decision-making

reasoning

Foundation Program

CbD

(assessor)

CbD

155

CbDHCAT

HCATmailFoundation Program

CbD:

:

.

. LQQOPERA

.

.

.

.

.

CbD

16 12

34

56

U/C (unable to comment)

HCAT

(video)

(video)

(calibration)

(instant & bidirectional feedback)

(DOPS) Direct Observation of Procedural Skill

Check List Mini-CEX procedures

?

DOPS

15-20

5

//

1. D011

2.() D021

3. D031

4. D041

5. D051

6. D061

7. D071

9. D091

10. D101

11. D111

12. D121

()( )

1 Venepuncture 9 ID Injection

2 Cannulation 10 IM Injection

3 () Blood Culture (Peripheral) 11 I V Injection

4 () Blood Culture (Central) 12 Urethral Catheterization

5 IV Infusions 13 Airway Care

6 ECG 14 NG Tube Insertion

7 Arterial Blood Sampling (Radial/Femoral stab)

15 Central vein Catheterization i.e. DLC, CVP

8 SC Injection 16 Organ puncture Liver, Kidney biopsy

DOPS

6 DOPS

:

:

:

: Mini-CEX CbD DOPS

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:

:

Mini-CEX, CbD, DOPS, OSCE

Mini-CEX 96 -11 96-11

98-6-26

99-7-2

99-12-17

99-12-17

100-2-21,6-23

101-4-25*

CbD 100-2 98-6-26

99/7-2

99-12-17

101-2-22

101-8-25*

DOPS 100-8 98-6/26

99-7-2

99-12-17

100-8-21,

100-11-2

101-6-28*

OSCE PGY1

101-6

102-6

98-6-26,12-26

99-7-2

101-12

102 1CbD 1020206()16:00

17:00 -16

3118 04-2463200053675

1

15:50-16:00

16:00-16:20

CbD

16:20-16:40

()

16:40-17:00

(

)

17:10

, 6, Min-CEX, CbD, DOPS2.

, .

, 1/20.

!, . (TEL: 53674)

2012

1 222 CbD

2 411 Mini-CEX

3 627 DOPS

4 822 CbD

5 1026 Mini-CEX

1026 X DOPS

6 1212 DOPS

, 6, Min-CEX, CbD, DOPS2.

, .

, 1/18.

!, . (TEL: 53674)

2013

1 26 CbD

2 43 DM Mini-CEX

3 65 DOPS

4 821 CbD

5 1030 Ankle sprain Mini-CEX

6 1218 DOPS

?

,

,

,

1007

CbD, Mini-CEX, DOPS

CbD, DOPS6

Mini-CEX 9

1-23-45-6

1-34-67-9

Mini-CEX

Case based Discussion

cc

teacher

CbD 10071026

184

173

2CbD

CbD

100 07-12

101 01-06

101 07-12

102 01-06

12 16 16 16

11 12 9 8

33 62 26 29

CbD 7:

7 :

1007-12 10101-6 1017-12 10201-6

()

1. 3.7420.682 3.7190.491 3.840.554 4.3850.697 0.6427 17.2% 0.001**

2. 3.7670.568 3.770.589 3.8850.766 4.2410.739 0.4747 12.6% 0.008*

3. 3.8930.497 3.8270.513 3.920.572 4.3570.678 0.4643 11.9% 0.005*

4. 3.8710.562 3.8770.381 3.840.473 4.1850.681 0.3142 8.1% 0.059

5. 3.8620.693 3.7640.508 3.9090.812 4.250.737 0.3879 10.0% 0.054

6. 3.8210.548 3.9430.497 3.8180.588 4.4170.776 0.5952 15.6% 0.002**

7. 3.9310.53 4.0190.416 4.1430.573 4.3460.745 0.4151 10.6% 0.020*

CbD

1007-12CbD 33

(n33)

1 C01-06 10 30%

2 C01-02 8 24%

3 C02-01 7 21%

(n 33)

1 C02-02 8 24%

2 C06-02 8 24%

3 C06-04 7 21%

CbD

10201-6CbD 29

(n 29)

1 C02-01

11 38%

2 C03-01 9 31%

3 C01-01 7 24%

(n 29)

1 C01-10 6 21%

2 C03-03 6 21%

3 C06-05 5 17%

Take Home Message

Mini-CEX, CbD,

DOPS

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