Flinders University, Adelaide 5001, South Australia, Australia.
Med Teach. 2011;33(10):783-97. doi: 10.3109/0142159X.2011.611022.
There are no scientific theories that are uniquely related to assessment in medical education. There are many theories in adjacent fields, however, that can be informative for assessment in medical education, and in the recent decades they have proven their value. In this AMEE Guide we discuss theories on expertise development and psychometric theories, and the relatively young and emerging framework of assessment for learning. Expertise theories highlight the multistage processes involved. The transition from novice to expert is characterised by an increase in the aggregation of concepts from isolated facts, through semantic networks to illness scripts and instance scripts. The latter two stages enable the expert to recognise the problem quickly and form a quick and accurate representation of the problem in his/her working memory. Striking differences between experts and novices is not per se the possession of more explicit knowledge but the superior organisation of knowledge in his/her brain and pairing it with multiple real experiences, enabling not only better problem solving but also more efficient problem solving. Psychometric theories focus on the validity of the assessment - does it measure what it purports to measure and reliability - are the outcomes of the assessment reproducible. Validity is currently seen as building a train of arguments of how best observations of behaviour (answering a multiple-choice question is also a behaviour) can be translated into scores and how these can be used at the end to make inferences about the construct of interest. Reliability theories can be categorised into classical test theory, generalisability theory and item response theory. All three approaches have specific advantages and disadvantages and different areas of application. Finally in the Guide, we discuss the phenomenon of assessment for learning as opposed to assessment of learning and its implications for current and future development and research.
医学教育评估中没有独特的科学理论。然而，相邻领域中有许多理论可以为医学教育评估提供信息，近几十年来，这些理论已经证明了它们的价值。在本 AMEE 指南中，我们讨论了专长发展理论和心理测量理论，以及相对较新的和新兴的学习评估框架。专长理论强调了多阶段的过程。从新手到专家的转变的特点是概念从孤立的事实中聚集增加，通过语义网络到疾病脚本和实例脚本。后两个阶段使专家能够快速识别问题，并在其工作记忆中快速准确地表示问题。专家和新手之间的显著差异并不是因为拥有更多的显性知识，而是因为他们的大脑中知识的组织更优越，并与多个真实经验相匹配，不仅使问题解决得更好，而且使问题解决得更有效率。心理测量理论侧重于评估的有效性——它是否测量了它声称要测量的内容，以及可靠性——评估结果是否可重复。有效性目前被视为建立一系列论点，说明如何最好地观察行为（回答多项选择题也是一种行为）可以转化为分数，以及如何在最后利用这些分数来推断感兴趣的构念。可靠性理论可以分为经典测试理论、可概括性理论和项目反应理论。这三种方法都有其特定的优缺点和不同的应用领域。最后，在指南中，我们讨论了学习评估与学习评估的现象及其对当前和未来发展和研究的影响。
