美国国家医学考试委员会（NBME）外科临床知识水平测试是否会对美国医师执照考试第一步（USMLE Step 1）的成绩造成“双重不利影响”？
Does the NBME Surgery Shelf exam constitute a "double jeopardy" of USMLE Step 1 performance?
作者信息
Ryan Michael S, Colbert-Getz Jorie M, Glenn Salem N, Browning Joel D, Anand Rahul J
机构信息
Virginia Commonwealth University School of Medicine, 1201 East Marshall Street, Richmond, VA, 23298, USA.
University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT, 84132, USA.
出版信息
Am J Surg. 2017 Feb;213(2):325-329. doi: 10.1016/j.amjsurg.2016.11.045. Epub 2016 Dec 13.
BACKGROUND
Scores from the NBME Subject Examination in Surgery (Surgery Shelf) positively correlate with United States Medical Licensing Examination Step 1 (Step 1). Based on this relationship, the authors evaluated the predictive value of Step 1 on the Surgery Shelf.
METHODS
Surgery Shelf standard scores were substituted for Step 1 standard scores for 395 students in 2012-2014 at one medical school. Linear regression was used to determine how well Step 1 scores predicted Surgery Shelf scores. Percent match between original (with Shelf) and modified (with Step 1) clerkship grades were computed.
RESULTS
Step 1 scores significantly predicted Surgery Shelf scores, R = 0.42, P < 0.001. For every point increase in Step 1, a Surgery Shelf score increased by 0.30 points. Seventy-seven percent of original grades matched the modified grades.
CONCLUSION
Replacing Surgery Shelf scores with Step 1 scores did not have an effect on the majority of final clerkship grades. This observation raises concern over use of Surgery Shelf scores as a measure of knowledge obtained during the Surgery clerkship.
背景
美国国家医学考试委员会外科专业考试（外科架上考试）的分数与美国医师执照考试第一步（第一步考试）的分数呈正相关。基于这种关系，作者评估了第一步考试分数对外科架上考试的预测价值。
方法
在一所医学院，将2012 - 2014年395名学生的外科架上考试标准分数替换为第一步考试标准分数。采用线性回归来确定第一步考试分数对外科架上考试分数的预测效果。计算原始（有架上考试）和修改后（有第一步考试）实习成绩之间的匹配百分比。
结果
第一步考试分数能显著预测外科架上考试分数，R = 0.42，P < 0.001。第一步考试分数每增加1分，外科架上考试分数增加0.30分。77%的原始成绩与修改后的成绩相匹配。
结论
用第一步考试分数取代外科架上考试分数对大多数最终实习成绩没有影响。这一观察结果引发了人们对外科架上考试分数作为外科实习期间所学知识衡量标准的担忧。
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