社團法人臺灣臨床藥學會

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【原著】建立實習藥學生對病人用藥指導之迷你臨床演練評量
The Mini Clinical Evaluation Exercise for Assessing Counselling Performance of Pharmacy Interns
糖尿病病人用藥指導、迷你臨床演練評量(mini-CEX)、藥學教育、mini-CEX, counselling competence, counselling assessment, pharmacy education
張瓊云Chiung-Yun Chang 、陳秀美Hsiu-Mei Chen 、顏志和Chih-Ho Yen 、劉媖媚Ying-Mei Liu 、湯念湖 、陳本源Been-Yuan Chen
1台中榮民總醫院藥劑部
本研究以實習藥學生面對真實病人,進行迷你臨床演練評量(mini-Clinical Evaluation Exercise, mini-CEX),經由直接觀察實習藥學生衛教糖尿病病人,以多面向與九分制之評量方式進行評估,多面向評估包括:專業性與溝通技巧評估。並透過病人對疾病與用藥之認知性評估、指導藥師對實習藥學生之評估、實習藥學生自我評估及檢視執行之成效。
本研究共有23名實習藥學生參與,評量時的直接觀察時間,平均為17.1 ± 4.5分鐘、評量後指導藥師對實習藥學生之立即回饋平均為10.3 ± 3.0分鐘。病人之疾病與用藥認知性評估,經實習藥學生指導前、後,正確率分別為60.9% 與95.0%(P < 0.0001);指導藥師對實習藥學生評估之平均分數為6.5 ± 0.8;實習藥學生演練前後之自我能力評估,由4.3 ± 1.4進步至6.7 ± 0.8,具有統計上之差異(P < 0.0001)。
由本研究發現,實習藥學生經mini-CEX評量後自評用藥指導能力有顯著進步,並且幫助病人對於藥物與疾病知識的了解。

A new developed Mini Clinical Evaluation Exercise (mini-CEX) for pharmacy interns face the real patients and pharmacy interns were evaluated and given feedback through directly observing the performance of professionalism and communication-skills during counselling with diabetes mellitus patients. The evaluative outcomes included the cognitive assessment to patient, self-assessment of the pharmacy trainee and overall competence rating from the attending pharmacist.
Twenty-three pharmacy trainees, the average time of observation and feedback take 17.1 ± 4.5 minutes and 10.3 ± 3.0 minutes, respectely. After the Mini-CEX, the correct ratio of cognitive assessment to patient was increased from 60.9% to  95.0% (p<0.0001); the average rating of self-assessment was increased from baseline 4.3±1.4 to 6.7 ±0.8. (p<0.0001). The overall competence rating from the attending pharmacist was 6.5±0.8.
From this study, pharmacy interns’ self-assessment of their counselling performance and cognitive assessment of patients showed improvement after Mini-CEX.
 
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