Jozefowicz Ralph F, Koeppen Bruce M, Case Susan, Galbraith Robert, Swanson David, Glew Robert H
Department of Neurology, University of Rochester School of Medicine, New York , USA.
Acad Med. 2002 Feb;77(2):156-61. doi: 10.1097/00001888-200202000-00016.
Most medical schools test their students throughout the curriculum using in-house examinations written by the faculty who teach the courses. The authors assessed the quality of in-house examinations used in three U.S. medical schools.
In 1998, nine basic science examinations from the three schools were gathered and each question was subjected to quality assessment by three expert biomedical test developers, each of whom has had extensive experience in reviewing and evaluating questions for the United States Medical Licensing Examination (USMLE) Steps 1 and 2. Questions were rated on a five-point scale: 1 = tested recall only and was technically flawed to 5 = used a clinical or laboratory vignette, required reasoning to answer, and was free of technical flaws. Each rater made independent assessments, and the mean score for each question was calculated. Mean quality scores for National Board of Medical Examiners (NBME) who were trained question writers were compared with the mean scores for question writers without NBME training. The raters' quality assessments were made without knowledge of the test writers' training background or the study's hypothesis.
A total of 555 questions were analyzed. The mean score for all questions was 2.39 +/- 1.21. The 92 questions written by NBME-trained question writers had a mean score of 4.24 +/- 0.85, and the 463 questions written by faculty without formal NBME training had a mean score of 2.03 +/- 0.90 (p <.01).
The in-house examinations were of relatively low quality. The quality of examination questions can be significantly improved by providing question writers with formal training.
大多数医学院校在整个课程体系中通过由授课教师编写的校内考试来测试学生。作者评估了美国三所医学院校所使用的校内考试的质量。
1998年，收集了这三所学校的九门基础科学考试试卷，每道题由三位生物医学测试开发专家进行质量评估，这三位专家都在美国医师执照考试（USMLE）第一步和第二步的题目审查与评估方面拥有丰富经验。题目按照五分制进行评分：1 = 仅测试记忆且存在技术缺陷至5 = 使用临床或实验室案例，需要推理作答且无技术缺陷。每位评分者独立进行评估，并计算每道题的平均得分。将接受过美国国家医学考试委员会（NBME）培训的出题者所出题目与未接受NBME培训的出题者所出题目进行平均质量得分比较。评分者在不了解出题者培训背景或研究假设的情况下进行质量评估。
共分析了555道题目。所有题目的平均得分为2.39±1.21。接受过NBME培训的出题者所出的92道题目的平均得分为4.24±0.85，未接受正式NBME培训的教师所出的463道题目的平均得分为2.03±0.90（p<.01）。
校内考试质量相对较低。通过为出题者提供正式培训，考试题目质量可得到显著提高。
