引用本文:张东海1 马秀华2 赵留庄2 刚君1 刘双1.病例导入式试卷在两届“3+2”助理全科医师培训《临床综合课程》结业测试中的应用效果分析[J].中华医学教育探索杂志,2020,(5):521~525
病例导入式试卷在两届“3+2”助理全科医师培训《临床综合课程》结业测试中的应用效果分析
Application of case-introduced papers in Clinical Comprehensive Course graduation test for “3+2” assistant general practitioners training of two batches
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中文关键词:  临床综合课程  病例导入式教学  简要病例题干题  “3+2”助理全科医师培训  
英文关键词:Clinical integrated curriculum  Case introduction teaching  Brief case questions  "3+2" assistant general practitioners training  Examination paper analysis
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张东海1 马秀华2 赵留庄2 刚君1 刘双1 1首都医科大学大兴医院科教科 1026002首都医科大学大兴医院院部 102600 
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中文摘要:
      目的 分析“3+2”助理全科医师培训《临床综合课程》2015级与2016级结业考试病例导入式试卷设计与答题情况,为教学中强化学员的临床问题综合分析能力提供参考。方法 该类试卷的部分试题编制采用“简要病例题干题”形式。计算两届学员试卷难度系数、区分度及信度,比较学员对不同题型(单选题、简要病例题干题)的回答情况。采用SPSS 15.0对相应数据行卡方检验或t检验。结果 两届试卷及组卷的两部分试题均符合考查目的及培训课程目标,难度系数、区分度、信度均较为合理。两届试卷的单选题难度系数差异有统计学意义(P<0.05);两届试卷的“简要病例题干题”区分度差异有统计学意义(P<0.05)。两届学员的试卷平均成绩差异有统计学意义(P<0.01)。考试各分数段学员频数分布在单选题得分上的差异有统计学意义(P<0.01);两届学员的单选题平均得分差异有统计学意义(P<0.01)。结论 两届学员对“简要病例题干题”均能接受;该题型对学员的要求更高,可有效区分学员能力状况。整体来看,助理全科医师培训中推进病例导入式教学的努力颇有成效。
英文摘要:
      Objective To analyze the design and test results of case-introduced papers in Clinical Comprehensive Course graduation test for assistant general practitioners of batch 2015 and 2016, so as to provide references for enhancing the comprehensive abilities of students to analyze clinical problems during training. Method Brief cases were introduced to part of the questions in the paper. The difficulty coefficient of the paper and the degree of distinction and reliability of the test results of students in the two batches were calculated and analyzed, and the results of their answers to different questions (single choice questions & brief case-introduced questions) were compared. SPSS 15.0 was used to perform chi-square test or t-test. Results ①The test papers for the two batches and the two parts in the papers all conformed to the testing purpose and have achieved the objective of training. The difficulty coefficient of the paper and the distinction and reliability degrees of the results were all reasonable. ②There was a statistically significant difference in the difficulty coefficient of the single choice questions in the papers of the two batches (P<0.05), but no significant difference in the brief case-introduced questions (P>0.05). ③There was no statistical difference in the difficulty coefficient of test questions in the two papers (P>0.05), but a statistically significant difference was found in the difficulty coefficient of brief case-introduced questions (P<0.05). ④There was a significant difference in the average scores of students in the two batches (t=8.18, P<0.01) and in the frequency distribution of each fraction frequency in the "single choice question" (P<0.01), but no difference in the frequency distribution of brief case-introduced questions (P>0.05). ⑤There was a significant difference in the average scores of single choice questions of students in the two batches (P<0.01), and no statistically significant difference in the average scores of brief case-introduced questions (t=1.22, P>0.05). Conclusion Students of batch 2015 and 2016 accepted the "brief case-introduced questions". These questions requires students with greater abilities, thus can effectively distinct their training outcomes. Generally speaking, introduction of cases in the teaching of assistant general practitioners has made great achievements.
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