Kushner Robert F, Butsch W Scott, Kahan Scott, Machineni Sriram, Cook Stephen, Aronne Louis J
a Department of Medicine , Northwestern University Feinberg School of Medicine , Chicago , Illinois , USA.
b Department of Medicine , Massachusetts General Hospital/Harvard Medical School , Boston , Massachusetts , USA.
Teach Learn Med. 2017 Apr-Jun;29(2):123-128. doi: 10.1080/10401334.2016.1250641. Epub 2016 Dec 29.
Phenomenon. As one of the most common chronic disease affecting adults and children, obesity is a major contributor to noncommunicable diseases, both nationally and globally. Obesity adversely affects every organ system, and as such it is imperative that the United States Medical Licensing Examination (USMLE) adequately assesses students' knowledge about the science and practice of obesity management. The purpose of this study was to evaluate the coverage and distribution of obesity-related items on the three USMLE Step examinations.
Examination items that included obesity-related keywords were identified by National Board of Medical Examiners (NBME) staff. A panel of 6 content experts evaluated all items and coded obesity-relevant items using the American Board of Obesity Medicine (ABOM) test outline rubric into 4 domains and 107 subdomains.
There were 802 multiple-choice items containing obesity-related keywords identified by NBME, of which 289 (36%) were identified as being relevant to obesity and were coded into appropriate domains and subdomains. Among the individual domains, the Diagnosis & Evaluation domain comprised most of the items (174) for all 3 Step examinations. Fifty-eight percent of items were represented by 4 of 17 organ systems, and 80% of coded items were represented by 6 ABOM subdomains. The majority of obesity-coded items pertained to the diagnosis and management of obesity-related comorbid conditions rather than addressing the prevention, diagnosis, or management of obesity itself. Insights. The most important concepts of obesity prevention and treatment were not represented on the Step exams. Exam items primarily addressed the diagnosis and treatment of obesity-related comorbid conditions instead of obesity itself. The expert review panel identified numerous important obesity-related topics that were insufficiently addressed or entirely absent from the examinations. The reviewers recommend that the areas identified for improvement may promote a more balanced testing of knowledge in obesity.
现象。肥胖是影响成人和儿童的最常见慢性病之一，在国内和全球都是非传染性疾病的主要促成因素。肥胖会对每个器官系统产生不利影响，因此美国医师执照考试（USMLE）必须充分评估学生对肥胖管理科学与实践的知识掌握情况。本研究的目的是评估肥胖相关题目在USMLE三步考试中的覆盖范围和分布情况。
美国医学考试委员会（NBME）工作人员识别出包含肥胖相关关键词的考试题目。一个由6名内容专家组成的小组对所有题目进行评估，并使用美国肥胖医学委员会（ABOM）考试大纲评分标准将与肥胖相关的题目编码到4个领域和107个子领域中。
NBME识别出802道包含肥胖相关关键词的多项选择题，其中289道（36%）被确定与肥胖相关，并被编码到适当的领域和子领域中。在各个领域中，诊断与评估领域在所有三步考试中包含的题目最多（174道）。58%的题目由17个器官系统中的4个系统呈现，80%的编码题目由6个ABOM子领域呈现。大多数肥胖编码题目涉及肥胖相关合并症的诊断和管理，而非肥胖本身的预防、诊断或管理。见解。肥胖预防和治疗的最重要概念在三步考试中未得到体现。考试题目主要涉及肥胖相关合并症的诊断和治疗，而非肥胖本身。专家评审小组识别出许多重要的肥胖相关主题在考试中未得到充分体现或完全缺失。评审人员建议，确定需要改进的领域可能会促进对肥胖知识进行更平衡的测试。
