Peterson Linda N, Rusticus Shayna A, Ross Linette P
L.N. Peterson is adjunct professor, Department of Cellular Physiological Sciences, and senior evaluation advisor, Evaluation Studies Unit, Medical Education, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. S.A. Rusticus is statistical analyst, Evaluation Studies Unit, Medical Education, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. L.P. Ross is senior psychometrician, Scoring Services Unit of Professional Services, National Board of Medical Examiners, Philadelphia, Pennsylvania.
Acad Med. 2015 May;90(5):684-90. doi: 10.1097/ACM.0000000000000643.
Accreditation standards require medical schools to use comparable assessment methods to ensure students in rotation-based clerkships and longitudinal integrated clerkships (LICs) achieve the same learning objectives. The National Board of Medical Examiners (NBME) Clinical Science Subject Examinations (subject exams) are commonly used, but an integrated examination like the NBME Comprehensive Clinical Science Examination (CCSE) may be better suited for LICs. This study examined the comparability of the CCSE and five commonly required subject exams.
In 2009-2010, third-year medical students in rotation-based clerkships at the University of British Columbia Faculty of Medicine completed subject exams in medicine, obstetrics-gynecology, pediatrics, psychiatry, and surgery for summative purposes following each rotation and a year-end CCSE for formative purposes. Data for 205 students were analyzed to determine the relationship between scores on the CCSE (and its five discipline subscales) and the five subject exams and the impact of clerkship rotation order.
The correlation between the CCSE score and the average score on the five subject exams was high (0.80-0.93). Four subject exam scores were significant predictors of the CCSE score, and scores on the subject exams explained 65%-87% of CCSE score variance. Scores on each subject exam-but not rotation order-were statistically significant in predicting corresponding CCSE discipline subscale scores.
The results provide evidence that these five subject exams and the CCSE measure similar constructs. This suggests that assessment of clerkship-year students' knowledge using the CCSE is comparable to assessment using this set of subject exams.
认证标准要求医学院校使用可比的评估方法，以确保参加轮转式临床实习和纵向综合临床实习（LIC）的学生实现相同的学习目标。美国国家医学考试委员会（NBME）临床科学科目考试（科目考试）被广泛使用，但像NBME综合临床科学考试（CCSE）这样的综合考试可能更适合LIC。本研究检验了CCSE与五项常用的科目考试的可比性。
2009 - 2010年，英属哥伦比亚大学医学院参加轮转式临床实习的三年级医学生在每次轮转结束后参加医学、妇产科、儿科、精神病学和外科的科目考试以进行总结性评估，并在年终参加CCSE以进行形成性评估。分析了205名学生的数据，以确定CCSE（及其五个学科子量表）分数与五项科目考试分数之间的关系以及临床实习轮转顺序的影响。
CCSE分数与五项科目考试的平均分数之间的相关性很高（0.80 - 0.93）。四项科目考试分数是CCSE分数的显著预测因素，科目考试分数解释了CCSE分数方差的65% - 87%。在预测相应的CCSE学科子量表分数时，每项科目考试的分数——而非轮转顺序——具有统计学意义。
结果提供了证据表明这五项科目考试和CCSE测量的是相似的结构。这表明使用CCSE对临床实习年级学生知识的评估与使用这组科目考试的评估具有可比性。
