Study of the objective evaluation for examinees' behavior and attitude in the OSCE

本研究对客观结构化临床考试（OSCE）医学面试的评价进行了研究，旨在提高OSCE医学面试的客观性。医学院校常用的标准化量表由两部分组成，一部分是进行访谈的行为评分，另一部分是对患者诊断信息的检测。在山口大学医学部，在<th>医院病房轮换前后，对5年制学生进行了两次由模拟患者（SP）支持的OSCE医学访谈。本研究对两次OSCE的调查结果进行了访谈8个项目、收集病人信息13个项目和SP评分的分析，并对2000 ~ 2002年3年间学生的行为和态度进行了数据分析。结果：病区轮换后护士的总成绩、进行访谈、收集病人信息、SP评价等方面的成绩均较轮换前有所提高。而2000年只有总分和SP分的差异有统计学意义。在评估的评分表项目中，收集患者信息的临床技能不令人满意，进行访谈的技能获得充分。现在，随着标准化的OSCE医学面试在日本所有医学院进行，未来需要进一步改善教育和引入普遍评价（全球评价）系统。

In this study, we examined the evaluation of OSCE(Objective structured Clinical Examination)medical interview to improve the objectivity of it. Medical interview in OSCE is usually evaluated the examinee's behavior and attitude using rating list. The standardized list mostly used in medical schools is composed of two parts, one is the score of behavior conducting the interview and the other is that of detection of diagnostic information from patients. In Yamaguchi University School of Medicine, to 5^<th> year student OSCE medical interview supported by the simulated patient(SP)is performed twice before and after ward rotation in the hospital. In this study, the results of two OSCEs were analyzed in scores of 8 items of conducting the interview, 13 items of collecting patient information and score of SP. Data analysis of the students' behavior and attitude were taken during 3 years from 2000 to 2002. As a result, total score, and scores of conducting interview and collecting patient information and SP's evaluation all increased after compared with before ward rotation. However, only the difference in the total score and SP's score in 2000 were statistically significant. In items of rating list of the evaluation, clinical skills of collecting patients information were unsatisfactory and that of conducting the interview were acquired adequately. Now, as the standardized OSCE of medical interview are performed at all medical schools in Japan, further improvement in the education and induction of generalized evaluation(global evaluation)system will be required in the future.