Turnbull J M
Med Teach. 1989;11(2):145-50. doi: 10.3109/01421598909146317.
Any reform of the current medical curriculum requires a reappraisal of the principles and practices of the evaluation system. The norm-referenced test which at this time is the primary method of evaluation was initially designed to rank order students for the purpose of selection. Difficulties arise when it is used, as it currently is for the assessment of competence. The norm-referenced test is often insensitive to instruction and, while it provides information regarding the relative strengths and weaknesses of students in comparison to their peers, it does not provide an estimate of the absolute level of performance achieved. In addition to promoting competition among students, the norm-referenced test is less suitable for programme evaluation. As it is the principal responsibility of a medical school to produce competent physicians and not to rank order them, it is more reasonable to compare student achievement to an external standard of performance or criterion. Criterion-referenced testing, then, is more suitable for the assessment of competence and, within this setting, percentage competency scores can be utilised when there is a need for the rank ordering of student achievement for the purposes of selection. It is recommended that criterion-referenced testing be the primary method of evaluation, as it best meets the objectives of the medical school by emphasising the achievement of clearly established external standards and, thereby, ensuring a high quality of performance.
当前医学课程的任何改革都需要重新评估评估体系的原则和实践。常模参照测试目前是主要的评估方法，其最初设计目的是为了选拔而对学生进行排名。当它像目前这样用于能力评估时，就会出现问题。常模参照测试通常对教学不敏感，虽然它能提供学生相对于同龄人相对优势和劣势的信息，但并不能估计学生实际达到的绝对水平。除了促进学生之间的竞争外，常模参照测试不太适合课程评估。由于医学院的主要职责是培养有能力的医生，而不是对他们进行排名，将学生成绩与外部表现标准或准则进行比较更为合理。因此，标准参照测试更适合能力评估，在这种情况下，当需要为选拔目的对学生成绩进行排名时，可以使用能力百分比分数。建议标准参照测试作为主要评估方法，因为它通过强调达到明确设定的外部标准，最能满足医学院的目标，从而确保高质量的表现。
