| Objective: Create a Computer-based Case Simulations with general practice characteristics that is suitable for the evaluation of clinical thinking ability of special post general practitioners,and evaluate its reliability,validity and feasibility,so as to provide new ideas for strengthening the evaluation of clinical thinking ability of special post general practitioners.Methods: 1.This study systematically understood the development status of general practitioners at home and abroad and the evaluation method of clinical thinking ability of general practitioners through literature research.2.Under the guidance of experts in the field of general practice and computer science,the multi-dimensional ability evaluation method was adopted to create the structural framework of Computer-based Case Simulations of general practice clinical thinking.3.A compilation of Computer-based Case Simulations,utilizing computer language,is based on the actual cases treated by general practitioners or graduate students in the department of general medicine at China Medical University.4.The reliability and validity were evaluated by expert meeting method.5.189 special post general practitioners who participated in the training were assessed.The total score of the assessment after training was significantly higher than that before training(p<0.05),and the assessment scores of all dimensions after training were also higher than that before training,among which the differences in the dimensions of consultation,physical examination,preliminary diagnosis and differential diagnosis,treatment plan,follow-up and management plan were statistically significant(p<0.05)..6.The results of satisfaction evaluation show that most general practitioners think that this Computer-based Case Simulation is realistic,interesting and feasible,which is helpful to improve clinical thinking ability.Results: 1.After several rounds of expert discussions,it was finally agreed that the clinical thinking ability of general practitioners should be evaluated through nine dimensions,including consultation,physical examination,auxiliary examination,preliminary diagnosis and differential diagnosis,treatment plan,follow-up and management plan,correlation with knowledge and understanding level,correlation with clinical reasoning level,and correlation with clinical thinking with general practice characteristics,and the computer simulation case of general practice should be constructed accordingly,In addition,the items and weights of Computer-based Case Simulations in general practice were determined to evaluate and assess the clinical thinking ability of students.2.Seven Computer-based Case Simulations were constructed based on real cases,including asymptomatic carotid stenosis,stable angina,ischemic stroke,primary hypertension,type 2 diabetes,long-term persistent atrial fibrillation and primary osteoporosis.3.The evaluation results of the expert meeting method show that the consistency test results among the evaluation dimensions show that Cronbach’s coefficient(Cronbach’sα)α= 0.823,which indicates that the reliability of each dimension in the Computer-based Case Simulation is high.After testing,the variance of the content validity index S-CVI index at the scale level reaches 0.906,which indicates that the effectiveness of the Computer-based Case Simulation is reliable.3.Evaluation results of expert meeting method: the internal consistency test results of each evaluation dimension showed that 4.The total score of the evaluation after training was significantly higher than that before training(p<0.05),and the evaluation scores of each dimension after training were also higher than that before training,including consultation,physical examination,preliminary diagnosis and differential diagnosis,treatment plan The difference between follow-up and management plan dimensions was statistically significant(p<0.05).5.The satisfaction evaluation results show that most general practitioners believe that this Computer-based Case Simulation is lifelike,interesting and highly feasible,which is helpful to improve clinical thinking ability.Conclusion: The construction of Computer-based Case Simulations with general practice characteristics and the use of its method of training and assessing the clinical thinking ability of general practitioners are of positive significance in promoting the learning interest of general practitioners,cultivating clinical thinking and improving the ability to solve problems. |
