以迷你臨床演練評量評估物理治療實習學生之學習成效

Application of Mini-Clinical Evaluation Exercise to Evaluate the Learning Outcomes of the Interns of Physical Therapy

目的：迷你臨床演練評量(mini-clinical evaluation exercise, mini-CEX)用以評估學生在臨床教育中知識、技能與態度的表現，然而以mini-CEX呈現物理治療實習學生之學習成效的研究甚為稀少。本研究目的利用mini-CEX檢視學生在實習階段的學習成效。方法：研究收集自2018年7月至2020年4月間某醫學中心復健科物理治療實習學生在四大專科(骨科、神經、小兒、心肺)的mini-CEX分數進行回溯性分析。統計分析使用魏克森符號等級檢定法比較期中評核和期末評核的分數差異，顯著差異訂為p<0.05。結果：共收集47位學生的mini-CEX分數進行分析。結果顯示，期中評核與期末分數分別集中於3分和4分，代表多數實習學生在實習後可達到要求(satisfactory)的標準；骨科、神經與心肺在期末評核的分數皆顯著提升，小兒部分僅在身體檢查和諮商衛教兩項達顯著進步。結論：本研究利用mini-CEX呈現實習學生於各面向的學習成效，提供臨床老師與學校了解學生在實習階段的臨床表現，並作為臨床教學改進的參考。

Objectives. Mini-CEX is a useful tool for assessing clinical competences including knowledge, skills and attitude. However, lack of studies used the mini-CEX to evaluate the clinical competence in the interns of physical therapy. The purpose of this study was using mini-CEX to assess the learning outcomes of interns in physical therapy.
Methods. Secondary data analysis was used to conduct this study. Data were collected from the department of rehabilitation in a medical center from July 2018 to April 2020. Four professional fields which contained orthopedic, neurology, pediatric and cardiopulmonary were analyzed in this study. Data analysis used wilcoxon signed-rank test to compare the difference between midterm and final stage of practical training. The significant level was set at p<0.05.
Results. Total of 47 interns were included in this study. The scores of midterm and final stage of practical training were 3 and 4 respectively which represented that most of the interns could meet the satisfactory criterion after training. The scores of final stage improved significantly in the orthopedic, neurology and cardiopulmonary. However, in the pediatric, significant difference only showed on physical examination and counseling skills.
Conclusion. Mini-CEX is a useful assessment tool for physical therapy education that can represent the learning outcomes in the practical training. Teachers in the clinics and schools can understand the students’clinical performance during internship and take as a reference for improving the clinical education.