应用一致性检验评价神经心理学情境教学效果初探

Effects of teaching in actual scene on neuropsychology by consistency check

  • 摘要: 目的 探讨一致性检验与“情境教学”等多种教学方法相结合对于神经心理学临床教学效果的影响。 方法 2009年6 -8月解放军总医院南楼神经内科对21个部队医院100名参与“中国老年退伍军人认知功能障碍现况调查”项目的医护人员及研究生,分3次在北京进行蒙特利尔认知评估量表协和版[Peking Union Medical College Hospital (PUMCH) Version of Montreal Cognitive Assessment,MoCA-P]测评方法培训。培训中模拟临床实际“情境”进行演练检测,并通过学员评分中位数与标准评分是否一致进行一致性检验,针对一致性检验发现的问题开展二次培训。 结果 第1次培训后一致性检验结果显示,MoCA-P中“复制立方体、画钟表、命名、连续减7、句子复述、词语流畅性、抽象”7个分项目,学员未能很好掌握测评方法,学员评分中位数与标准评分存在差异;其他5个分项目学员评分中位数与标准评分一致。针对评分不一致的7个分项目,对复杂的评分标准、修订后测评方法与英文原版等存在差异之处以及学员的典型错误进行二次培训后,除“抽象”外所有分项目学员评分结果与标准评分均达到一致。 结论 “一致性检验”与“情境教学”等多种教学方法相结合,可有效地改善神经心理学临床教学效果。

     

    Abstract: Objective To explore the effect of consistency check combined with teaching in actual scene on clinical teaching practice of neuropsychology. Methods From June to August in 2009, 100 medical staff from 21 military hospitals were trained for the assessment methods of Peking Union Medical College Hospital [PUMCH] version of Montreal Cognitive Assessment (MoCA-P)by traditional lecture, illustration and practice in Beijing for 3 times. During training period, teaching in actual scene combined with consistency check was performed. The median and the standard score of these staff were tested by consistency check, and the problems found by consistency check would be solved during the second training program. Results The results of consistency check after the first training found that the median and the standard scores of medical staff showed significant differences in 7 subitems,including copy cube, draw clock, naming, serial 7 subtraction, repeat, fluency and abstraction. The median scores of medical staff in another 5 subitems were consistent with the standard scores. After further training which was focused on the complicated evaluation standard, the differences in revised evaluation method and original English edition and typical mistakes in staff due to the unconsistency of scores in 7 subitems, the consistency of all scores improved significantly except the median and the standard score of abstraction. Conclusion The consistency check combined with multiple teaching methods including teaching in actual scene can improve the quality of clinical teaching practice of neuropsychology.

     

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