A Study On The Evaluation Index System Of Clinical Thinking Ability Of Medical Students And Demonstration

Objective To establish a scientific, systematic and operational evaluation system of clinical thinking ability to provide evaluation tool for medical students. At the same time,through using this evaluation system on the spot, we can know the present clinical thinking level of medical undergraduates and postgraduates of Qingdao University.Method On the basis of the literature review and expert interviews, forming an initial semi-structured evaluation index system. We conducted two rounds of Delphi consultation with thirty experts. The evaluation index system of clinical thing ability was finally set up. We made the questionnaire according to the evaluation index system.Selected undergraduates and postgraduates of medical students of Qingdao University of demonstrative study on the spot. Weighting method, mean, SD and percentage were used for evaluation the level of clinical thinking of medical students. T-test, ANOVA and Chi-squared test were used for the differences of different grades and different majors.Multiple linear regression analysis was used for the influence factors of clinical thinking level of medical students.Results The index evaluation of clinical thinking ability was established after two rounds of Delphi method, which consists of three main indicators and twenty-four items.The three first-class indicators are clinical thinking ability, systemic thinking ability and evidence-based thinking ability, with weight 0.5728,0.2500,0.2222 respectively. The positive coefficient for two rounds of Delphi method was both 100%. The authoritative coefficient was 0.70-0.90. In the empirical research,the general score of clinical thinking ability in 360 medical undergraduate students were 68.89±10.19, and the score of nursing major and clinical major was 68.14±9.13,68.14±9.13 respectively. There’s no significant difference comparing the scores of nursing undergraduates to the scores of clinical medical undergraduates(P<0.05). The score of senior class,junior class and fifth class were 65.42±9.42、69.21±9.99、72.03±10.14 respectively. There’s significant difference comparing the scores of different grades(P>0.05). The multiple linear regression analysis shows that the practice time,the frequency of departments rounds and case discussions,the frequency of academic activities,and the teacher’s satisfaction of case writing are significantly related to the clinical thinking ability of medical undergraduates.The general score of clinical thinking ability in 180 medical graduate students were 74.64±10.67, and the score of nursing major and clinical major was73.67±9.37、75.06±11.19 respectively. There’s no significant difference comparing the scores of nursing graduate students to the scores of clinical medical graduate students(P<0.05).The score of first class,second class and third class were 67.04±9.78、73.90±7.99、82.97±7.49 respectively. There’s significant difference comparing the scores of different grades(P>0.05).The multiple linear regression analysis shows that the practice time, reading professional literature quantity, and starting research sooner or later,are significantly related to the clinical thinking ability.Conclusions Through using Delphi method reasonably, we set up the evaluation index system for clinical thinking ability of medical students, with integral contents and strong operability. The evaluation index system can reflect the clinical thinking level of medical students. The empirical study results shows that the clinical thinking ability level of medical students were in better level, but can not reach the level of current medical education. Thus, we must captured the influence factors of clinical thinking ability.Continue to reform its teaching mode in medical education in order to raise the level of medical students’ clinical thinking.