Y HQC VigT NAM THANG 9 . S 6 2/2014
LirCCNG GlA MON TIEN LAM S A N G V A P H A N HOI CUA G I A N G VIEN TAI TRiraNG DAI HOC Y HA NOI
T 6 M TAT
Ngiiien ciitj du'dc thi/c hien vdi 67 giang vien.
Mye tieu: 1. Mo ta phan hoi ciia giang vien ve not dung ky OSPEs hai mon Tien lam sang Ngi, Ngoai. 2.
Tim hieu y kien ciia giang vign ve hinh thu'c to chu'c OSPEs cho hai mon hpc nay tsi tnrdng Oai hoc Y i^a Noi. KSt qua: Yeu cau ky nang, cau hoi kien thu'c phii hdp vdi noi dung va muc tieu hoc t|p (98,5%, 94%).
Vat lieu lu'dng gia day dii, thich hdp (92,5%; 91%). To cliifc ky uii rat tot (97%). SU phoi hdp giCTa cac bp mdn r§t tot (100%). OSPEs co gia trj, cong bang 6i lu'dng gia k? nSng tien lam sang cho sinh vien (97%) va can dUdc to chirc thu'dng xuy§n (98,5%). Ket lu|n: LuWtg gia bSng OSPEs hai m6n Tien iam s&ng Npi, Ngoai da phii hdp vdi npi dung va muc tieu hpc t$p. iio?t dpng to chu'c OSPEs du'dc thuc hien t5t. Da so giang vien hai long vdi lu'dng gia ky nang bang OSPEs.
SUIVIMARY
SKILLS ASSESSMENT BY OSPES AND FACULTY'S FEEDBACK AT HANOI MEDICAL U N I V E R S I T Y The study was conducted viiHi 67 faculty members. Objectives: 1. To describe facuit/s feedback dn the content of OSPEs for tv^o subjects of Skills b-alning of Internal Medicine and Surgery. 2. To find faculty's opinions about organizational forms OSPEs for two subjects at iianoi Medical University. Subjects and methods: Lecturers of skills training In HMU. Research methodology; cross-sectional descriptive. Results:
Content of OSPEs were dear (98.5%). Question of knowledge cdnsisted with the content and learning objectives (94%). Materials evaluated fuily appropriate (92.5%, 91%). Organization was very gpod (97%).
"Tile cooporation between all departments was very good (100%). OSPEs have validity and reliability to assess skills for students (97%) and should be held regularly (98.5%). Conclusion: Skills assessment by OSPEs for two subjects already consisted with the
* Bp mon Giao dye y hpc v& Ky nang tien l§m sang, Truflng Dal hpc Y Ha Npl
CJiju trach nhiem chinh: L e T h u H o a Email: lethuhoagihmu.edu.vn Dt: 0988.891.693 Phan bien khoa hpc: PGS.TS Pham VSn Than NgJy nhan bai: 2.7.2014
Le Thu Hoa*
content and learning objectives. OSPEs organization had been done well. The majority of teachers were satisfied with assessment skills by OSPEs.
L DAT
VXNo l
Tien lam sang la mon hoc m6l tai truing OHYHN. Trong chu'dng trinh dao tao bac sT da khoa, day va hpc ky nang (tien !am sang) duWc xep vao khoi kien thifc chuyen nganh va du'dc thifc hien tru'dc khi sinh vien di hoc cac mon lam sang d benh vien [ 1 ] .
OSCEs/OSPEs (Objective Structured Clinical/Practical Examinations) hay con gpi la lu'dng gia lam sang/thi/c hanh theo cau true khach quan (chay tram) la mpt trong nhffng hinh thu'c lu'dng gia ky nang t o t nhat hien nay. Hoat dong lu'dng gia bang OSPEs cho mon hoc Tdn lam sang da du'dc thu'c hien tai mpt so tru'dng Dal hpc Y ciia Viet Nam.
Nghien cifu du'dc thiTc hien trong ky OSPEs hai mon hpc Tien lam sang Npl, Ngo?l nam hpc 2010-2011 tai tru'dng OHYHN V(3I mgc tiSu: 1. Md ti phin hpi cua gting vien ve npi dung ky OSPEs hai mdn Tien iam sing Npi, Ngpai 2. Tim hiSuf kien aia giang vien ve hinh thiit td'chiic vi vai trd aia OSPEs chp hai mdn hpc niy tai tiVdng Bai hpc Y Hi Npl.
M. OOI vj^fm \ik PHirofNG PHAP NGHIEN cCru
Z . l . Ooi tu'dng n g h i i n a h i : Giang vien mon Tien lam sang Noi, Ngoai tru'dng DHYHN.
2.2. T h i e t k e nghien cti'u: mo ta d t ngang 2.3. C 3 m § u : toan bo giang v l i n tham gia ky OSPEs (2010-2011)
2.4. Cong cu; 5p cau hoi tii d l i n . 2 . 5 . xa l y sS lieu: sir dung phan mem Epidata va Stata.
2 . 6 . Oao du'c t r o n g n g h i i n cu'u: OSI tu'dng tham gia du'dc glal thich ve noi dung, phu'dng phap nghien cifu... Tliong tin se du'dc m l hda. Dol tu'dng t i f nguyen va ky vao ban cam ket tru'dc khi tham gia ngiiien ciru.
Y HOC VigT NAM T H A H G 9 - SO 2/2014
III. KET QuA
Oa CO 67 giang vien tham gia. Ty le nam/niJ' = 47/20 (70,1%; 29,9%) 3.1. Phan hoi cua giang vien ve noi dung ky OSPEs 3.1.1. Ngi dung lu'dng gia
Hinh 1. Y kien giang vien ve ngi dung OSPEs
r B K h d n g d d n g y a O d n g y + R 4 t d d n g y
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Nh$nx4t;yeu cau ky nang phu h^p muc tieu hpc tap (98,5%), thdi gian vtra du (97%), ket lidp cSu hoi ly thuy§t thfch hdp (91%), cau hoi ly thuyet phu lidp vdi npi dung hpc tap (94%).
3.1.2. V$tli$u lupng gli
Hinh 2. Y kien giang vien v§ vat lieu cho OSPEs
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Nh$n xit! Vat lieu phuc vu ky OSPEs da dUdc chuan bj tot; mo hinh, dung cu day dCi (92,5%), tai ll$u du (91%), so tram thi du (91%), hinh thij'c tinh diem chinh xac, cong bSng (88,1%)..
3.2. •i klSn g l i n g vien ve hinh thij'c tS chO'c OSPEs 3.2.1. T£chit Chung
Hinh 3. y kjgn glang vien ve to chut chung ky OSPEs
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Nh$n xit! KJi OSPEs du'ijc to chu'c rat tot (97%), nhom sinh vien du'dc to chu'c tot (100%), thdi gian dil theo ca r3t thich hdp vdi glang vien (98.5%), sy hdp tac giiia bp mon GDYH-Kims va cac bo mon rat t a (100%), ban tS chu'c da tao dieu kien rat tot cho cac giang vien (100%).
Y HQC VigT NAM THANG 9 - SO 2/2014
3.2.2. Vai tro aia OSPEs
Hinh 4. Y kien giang vien ve vai tro cua OSPEs
OSPEe thich hop d i OSPEs c i n du'O'c t6 l u ^ n s gia ky n i n g t)«n chux: thu-o-ng xuy*n l i m sang cho sinh d i lu-^-ng gia hy nang
vlsn liAnlam sang
Nh$n xii: Ba so giang vien dong ii rSng OSPEs la ky thi co gia trj va cong bSng (97%), thich hijp de iu'dng gi^ ky nang tlSn iam sang (100%), can du'dc to chu'c thirdng xuyen (98,5%) va OSPEs lam giam ap ii/c Cham thi cho giang vien (98,5%).
IV. BAN LUAN
4.1. Phan h3l cua glang vlin ve n6l dung k^ OSPEs
4.1.1. Ngi dung luifng gli
Lu'dng gia ky nSng la boat dong quan trpng trong chu'dng binh dao tao y khoa. OSCEs/OSPEs da du'dc chirng minh la mpt hinh thu'c lu'dng gia CO gia trj, khach quan va cong bSng de iu'dng gia ky n3ng cua sinh vien [2]. Tir nhij'ng nam 1970, OSCEs da du'dc to chu'c thu'dng quy tai cac tru'dng E)ai hoc Y d My de lu'dng gia nang lu'c ciia sinh vien [3].
Theo Miller G.E., co bon mu'c dp iu'dng gia nang life thu'c hanh (ky nang): hieu biet ve ky nang (knows - knowledge), tim hi^u them ki§n thu'c ve ky nang (know how - competence), thu'c hien ky nang (show how - performance), va thirc hien dUdc ky nang mpt each ttr chii (does - action) [4]. Trong moi tru'dng mo phdng, ky nSng cua sinh vien thu'dng dUOc lu'dng gia d mii'c dp 2 (know how) va miJc do 3 (Show how) vdi OSCEs/OSPEs [2].
N3m 2001, "Hu'dng din cua To chirc Y te The gidi de dam bao chat iu'dng dao tao y khoa cd ban d khu viTc Tay Thai Binh DiTdng" neu ro cac phudng phap sir dung de iu'dng gia sinh vien can phai ket hdp giua lu'dng gia qua trinh va lutfng gia het mon, ket hdp giiia cau hdi kien thu'c va cac hinh thifc dac bi|t khac nhu' OSCEs [5].
Tai nhieu trudng bai hpc Y ciia Australia va New Zealand, OSPEs la t:at bupc de lu'dng gia ky nang Oen lam sang cho sinh vien nSm thif 2 va 3 [6].
Trong OSPEs, thdi gian tai timg tram thi la rat ngSn, do dd dS thi phai rai; ro ranp, chinh xac va phii hdp vdi muc tieu hpc tap. Ky OSPEs hai
mon Tien lam sang Npi, Ngoai da cd yeu tau kf ning phu hdp vdi muc tieu hoc tap (98,5%) va thdi gian tai moi tram la via dii desinh vien Uiiic hien ky nang theo yeu cau (97%).
Cac tram lu'dng gia kien thij'c la mpt phan khpng the thieu cua kj" OSPEs [7]. Trong ky OSPEs mon Tien lam sang Npi, Ngoai, sdkSth^
cau hdi kien thiic tai cic tram la thich lidp (91%)^
va cic ciu hdi kiin thiit phii hdp vdi muc tieii hpc tap (94%).
4.1.2. V^t ll$u luyng gii
Cong thu'c tinh diem dUdc cong bo cho sinh vien va giang vien tru'dc khi thi/c hien OSPEs, vS 88,1% giang vien dong <i rang cich tinh ileri trong ky OSPEs li thich hdp, cong bang.
Ky OSPEs can nhieu loai v$t lieu khac nhau, Ket qua nghien clJu cho thay ky OSPEs hai mon Tien lim sing Noi, Ngoai da dudc chuan bi rat tot, day dii md hinh, trang thiet'bl (92,5%), til lieu IWdng gii (91 %), nhdm ddng vai (92,4%).
Ngu'di benh ddng vai du'dc ySu cau tai cac tram ky nSng giao tieg ho^c th3m kham. Ky OSPEs da sir dung nhieu ioai mo hinh vdi hdn 200 lu'dt ngu'di benh ddng vai va 92,4% giang vien ddng y rSng nhdm ngu'di binh ddng vai da dWdc tpchiic tdt.
4.2. Y kien giang vien vie hinh thUrc tS chu'c OSPEs.
4.2.1. TSchu'c Chung
Moi ky OSPEs dUdc len ke hoach chi tiet tS dau khoa hpc. Ngon nhan lire du'dc'xay dimg duS tren sii hdp^ tic tot giiia Bp mdn GDYH-i<NTlS le cic Bg mon Npl, Hoi Slit cSp cud, Tim mack Huyet hpc vi tivyen miu, Ngpai (100%). Sii'w^
Y HOC VigT NAM THANG 9 - SO 2/2014 tac hieu qua giUa cac bo mon da dem lai thanh
cong cho ky thi.
Trong ky OSPEs, 67 giang vien da thy'c hien 200 lu'cft cham t h i , cung vdi 50 lu'dt giang vien giam sat. Ket qua nghien cu^i da cho thay ky lu'dng gia du'dc to chut rat tdt (97%); ban td chu'c da tao dieu kien rat thuan Idi cho giang vien cham thi (100%); thdi gian thi theo ca rat thich hdp vdi giang vien (98,5%), va nhdm sinh vien vao thi dudc to chu'c rat tot (100%). Ky OSPEs da dem lai su' thuan Idi va hai long cho ca giang vien, sinh vien, va du'dc giang vien danh gia la thanh a n g .
4.2.2. Val trd cua OSPEs.
OSCEs/OSPEs la hinh thu'c lu'dng gia nang li/c cua sinh vien dam bao du'dc mpi yeu cau cua mpt ky iuWng gia chuan nhu* tinh kha thi, tinh tin cay, tfnh gia tri, tinh phan loai cao [ 3 ] . Trong nghj@n ciiu nay, cac giang vien da dong y rang OSPEs la hinh thut hi'ch hdp de IWdng gia kp nSng tien lam sang cua sinh vien (100%), va rat (Sn difdc tochiyc thddng xuyen (98,5%).
MSI ky OSPEs gom rat nhieu tram thi khac nhau da tcio cd hpi cho sinh vien the hien nang lyc thyc hanh, vdi nhieu quy trinh, ky nSng, nen OSPEs la ky iupng gia cd tinii gia tri va cdng t^ng vdi sinh viSn (97%) Nhom glang vien cham thi du'dc tap huan tru'dc va co thdi gian lap ke ho^ch cho cong viec, do dd OSPEs du'pc danh gia la da tao dieu kien tiiuan ldi toi da va iam giam ap lut cham tiii cho giang vien (98,5%).
V. KET L U A N
1 . Npi dung lu'dng gia trong ky OSPEs hai mon Tien lam sang Npi, Ngoai da phu hdp vdi ngi dung va muc tieu hoc tap. Vat lieu lu'dng gia d^y du, tot.
2 . Hoat dpng chuan bl va to chu'c OSPEs du'pc thyc hien tot. Su" hdp tac giO'a cac bo mon rat tot. OSPEs la hinh thy'c lu'dng gia thi'ch hdp, cd gia tri va cong bang de iu'dng gia ky nang cho sinh vien.
TAI U|U THAM KHAO
1 . Bp Giao d^c va Dao t ^ o (2012), OiuiAKi trinh Imung giao due dai hoc. Khoi nganh Khoa hoc sdC khoe. Nganh Y da khoa. Trinh do dai hoc, 37 tiang. Ban hanh kem ttieo thong t y Oi/20i2/TT- B6D0T ngay 13/1/2012.
2. Gormley G. ( 2 0 1 1 ) , Summative OSCEs in undergraduate medicaf education, Ulster Med 1 80(3), 127-132
3. Turner J.L., Dankoski M.E. (2008), Objective structured clinical exams; a critical review, Famlniy medidne, 2008;40(8): 574-8.
4. Miller G.E. (1990), The assessment of clinical skills/competence/performance, Academk medicine, vol 65, No 9 September supplement.
5. World Health Oragnization (2001), WHO guidelines for quality assurance of t)asa m&dkal education in the Western Pacific Region, 80 pages 6. F a c u l ^ of Medicine University of Otago
(2013), f^B ChB Assessment policies and procedures 2013, 86 pages
7. Blundell A., Harrison R. (2010), OSCEs at a glance, Wiley-Blackwell, 232 pages.
GIA TRI CAC PHiraNG PHAP CHAN DOAN LAO DAI TRANG CO BIEN CHU'NG TAI BENH VIEN VIET Dl^C
T6M TAT
M^c dtch: Qua nghien cutj cic tru'dng hpp lao dai trSng ^DT) co bi§n chiitig dieu trt tai benh vi^n Vl?t Dti'c de nit kinh nghiem trong chan doan benh. Sff ll^u v i phuVng phSp nghiSn cu'u: Nghien culJ tien cu\i cac tru'dng hdp LOT co bien chutig dieu tri tai benh vien Viet Du'c tfr 2009 den 2011. Ket q u i : 22 truftng hdp LOT co bien chutig, trong dd nam chiem 8 1 % , tuS trung binh 44,8, tien si^ lao cd 40,9%. Trieu chtJ(hg chCi yeu la dau bung: 100%, roi loan tieu hoa 86%, sot 68%, Sn kem 50%. Bien chutig chinh Id khoi
* B^nh w$n Viet Difc
Chiu b^ch nhiem dii'nh: Nguyen OiJrc Chi'nh Email: rfi^r chinh 1960@vahoo.com^ Ot: 0912.396.753 Phin bien khoa hoc: PGS.TS Nguyen Du'c Tien Ngiy nh$n bai: 28.7.2014
Nguyen Dire Chinh*
u chiem 36,4%, tac ruot 31,8%. Chan doan hinh anh:
ngi soi 5/7, chup cat l(3p vi tfnh 4/5, chyp khung dai trang 4/4. K§t luan: Chan doan LOT co bi^n chutig kho, dac biet trong cap culi do dau hi^u khong dien hinh, khong Oiyc hien du'dc cac thSm do day du. Ket hdp tham kham lam san^ vdi nghien CLIU chan doan hinh anh se giup cho chan doan. Chup c3t Idp vi ti'nh, chup khung dai trang va npl soi va cac chan doan hinh anh CO gia tri.
Tit khoa: Lao rupt, bien chuhg lao ruot, chSn doan hinh anh benh tieu hoa
S U M M A R Y
VALUES OF D I A G N O S T I C PROCEDURES FOR C O M P U C A T E D COLONIC TUBERCULOSIS A T V I E T DUC HOSPITAL
