引用本文:王海明 刘道洪 蒋晖.临床实习标准化出科考核体系的建立及教育测量学评价[J].中华医学教育探索杂志,2018,17(10):1041-
临床实习标准化出科考核体系的建立及教育测量学评价
Establishment and educational measurement of department examination system of clinical practice internship
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中文关键词:  临床实习  出科考核  教育测量
英文关键词:Clinical internship  Department examination  Education measurement
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作者单位
王海明 刘道洪 蒋晖 510515 广州南方医科大学南方医院脊柱骨科(王海明、蒋晖)教务处(刘道洪) 
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中文摘要:
      目的 在科室层面建立临床医学专业通科实习标准化出科考核体系,并对该体系进行教育测量学评价。方法 选取2014年7月1日至2016年6月30日在某教学医院脊柱骨科实习的全部临床医学专业五年制、八年制学生(共327人)为对象,采用标准化的出科考核体系对实习生进行考核;应用一般描述性分析、项目相关性分析和评分者一致性分析等,评估该考核体系的内容效度、项目相关性和评分者一致性;使用SPSS 23.0进行统计分析。结果 有效纳入的实习生(共312人)总体平均分为(80.07±4.67),最低70.01分,最高90.01分,表明考核难度适中、极差合理、分数段分布均匀。理论、技能、病历、教师评分、奖励加分5项内容的标化回归系数分别为0.479、0.473、0.118、0.135和0.364,与各项目成绩占总成绩所赋权重基本吻合。评分者一致性方面,理论、技能和教师评价3项内容与总成绩的评分差异无统计学意义(P>0.05),一致性较好;病历、奖励加分2项内容的评分差异有统计学意义(P<0.05),一致性较差。结论 该出科考核体系基本能够满足全面、全程、定量、稳定反馈教学效果的要求。当然,出科考核体系仍需长期应用和反复校正,才能有效监控与促进教学质量。
英文摘要:
      Objective To set up a standardized examination system for clinical internship at the de-partment level, and to evaluate the system using educational measurement method. Methods All the 327 clinical five-year and eight-year intern trainees who took clinical internship in the spinal orthopedics de-partment of a teaching hospital from July 1, 2014 to June 30, 2016 were selected as the research subjects. All the subjects took the standardized examination, educational and measurement methods such as general descriptive analysis, project relevance analysis and grader consistency analysis were executed to assess the content validity of the system, the relevance of the project and the consistency of the scorers. Statistical calculation was executed by SPSS 23.0 software. Results The average score of all 312 trainees included was controlled at (80.07±4.67), the lowest score was 70.01, and the highest score was 90.01, which reflected that the overall difficulty was moderate, the difference was reasonable and the scores were evenly distributed. To the theory, skills, medical records, teachers' score and the reward plus, normalized regression coeffi-cients were 0.479, 0.473, 0.118, 0.135 and 0.364 respectively, which were in good agreement with the scores of each item in the total score. To the theory, skills and teacher evaluation, the analysis of variance of the total score showed that the P values were both ≥0.05 with no significant difference between the groups, so the consistency of the scorers were satisfactory. The P values of variance analysis of the two items of the medical record and bonus points were 0.000 and 0.002 respectively, with significant differences among the groups, the scorers were less consistent. Conclusion The standardized examination system can meet the requirements of comprehensive, full-scale, quantitative and stable feedback teaching effect. The system of internship practice examination must be able to withstand continuous implementation and repeated correc-tion over many years, so as to ensure the teaching quality.
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