关键词: 全科医学, 过程评价（卫生保健）, 形成性评价

Abstract: Background　Direct observation of procedural skills（DOPS） is a formative evaluation tool with teaching function for assessors to provide immediate assessment and feedback through direct observation of students' skills，which can evaluate students' learning process objectively and comprehensively. It is of great significance to introduce DOPS into teaching evaluation of general practice. Objective　To discuss the significance and effect of DOPS as formative evaluation tool in graduation internship in General Practice Department. Methods　A total of 72 seven-year clinical medical students of Grade 2013 in China Medical University were selected by cluster sampling from September to October in 2018. All students were randomly divided into experimental group and control group with 36 cases in each group by random number table method，and they were assigned to participate in a one-week internship in the General Practice Ward of the First Hospital of China Medical University. After the internship，a one-week clinical practice was conducted.In the control group，the traditional teaching method was used in the training of clinical practice skills.In the experimental group，formative evaluation with DOPS was conducted twice in the one-week course of clinical practice. The two groups were taught by the same teachers. At the end of rotation，mini-clinical evaluation exercise（Mini-CEX），clinical skill operation score，theoretical examination and questionnaire survey were used for teaching evaluation. Results　There was no significant difference between the experimental group and the control group in the theoretical test scores（P>0.05）. The clinical skill operation scores of the students in the experimental group and the control group were（76.67±6.20） and（72.50±7.66） respectively，and there was a significant difference between the two groups（P<0.05）. The Mini-CEX scores of the experimental group were higher than those of the control group in terms of physical examination，humanistic care，communication skills and overall performance（P<0.05）. The clinical operation time of DOPS was（11.32±1.76） min，the feedback time was（13.14±2.21） min，and the total time was（24.46±1.97） min. More than 80% of the students thought that DOPS was helpful to discover small problems in their operations and feel the attention and concern of teachers with strong feasibility. It could also improve operational skills and cultivate humanistic literacy and communication skills. Conclusion　Carrying out DOPS as formative evaluation tool in graduation practice of General Practice Department could improve students' clinical skills and Mini-CEX scores and improve the teaching effect effectively.

Key words: General practice, Process assessment（health care）, Formative assessment