Beullens Johan, Van Damme Bo, Jaspaert Hendrik, Janssen Piet J
Centre for Medical Education, Faculty of Medicine, KU Leuven, Belgium.
Med Teach. 2002 Jul;24(4):390-5. doi: 10.1080/0142159021000000843.
At the Faculty of Medicine of the KU Leuven a 'final' test is being developed, part of which consists of extended matching multiple-choice questions (EMQs). These are problem-oriented questions referring to a realistic case, with the correct answer to be chosen from a list of 7-26 possible answers. The same list can be used for several questions (cases). Staff members of 10 medical specialties have developed about 900 questions. In order to test the quality of these questions, they were submitted in series of 100 questions to 251 final-year students who were not specifically prepared for content, or for question format. The organization of the test ran without problems. It was possible to answer 100 EMQs within half a day (i.e. 4 hours). Fatigue had no measurable influence on the score over this period but increasing familiarity with the question format was observed. In order to obtain a reliable series of questions those questions that correlated negatively with the total score were deleted until a Cronbach alpha of 0.80 was reached. Split-half reliability coefficients were of the same order of magnitude. The score on a questionnaire concerning the perception of the test indicated poor face validity. The procedure of test construction gave arguments for content validity. The correlation between test score and total examination score of each of the 7 years of medical education was statistically significant, which indicates criterion validity. Therefore, starting from 100 EMQs per student it was possible to develop a reliable and valid test. EMQs seem to be appropriate for a final test of clinical knowledge in medical education.
在鲁汶大学医学院，一项“最终”测试正在研发中，其中一部分由扩展匹配多项选择题（EMQ）组成。这些是以问题为导向的题目，涉及一个实际病例，正确答案需从7至26个可能的答案列表中选出。同一列表可用于多个问题（病例）。10个医学专业的工作人员编写了约900道题目。为测试这些题目的质量，将它们以100题为一组提交给251名最后一年的学生，这些学生未针对内容或题型做特别准备。测试组织过程顺利。学生有可能在半天（即4小时）内回答100道EMQ。在此期间，疲劳对分数没有可测量的影响，但观察到学生对题型的熟悉程度在增加。为获得一系列可靠的题目，将那些与总分呈负相关的题目删除，直到达到0.80的克朗巴哈系数。分半信度系数处于同一数量级。一份关于对测试看法的问卷得分显示表面效度较差。测试构建过程为内容效度提供了依据。医学教育7年中每年的测试分数与总考试分数之间的相关性具有统计学意义，这表明具备效标效度。因此，从每名学生100道EMQ开始，有可能研发出一项可靠且有效的测试。EMQ似乎适用于医学教育中临床知识的最终测试。
