Lenz Holger, Opitz Ansgar, Huber Dana, Jacobs Fabian, Paik Wolfgang Gang, Roche Jörg, Fischer Martin R
Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Germany.
LMU München, Lehrstuhl für Empirische Pädagogik und Pädagogische Psychologie, München, Germany.
GMS J Med Educ. 2019 Feb 15;36(1):Doc2. doi: 10.3205/zma001210. eCollection 2019.
To develop a scientifically sound and standardized medical language examination for the State of Bavaria according to the requirements set forth by the 87 Conference of State Health Ministers. This (SAM, Language Test for Foreign Physicians) ought to become part of the licensing procedure for foreign physicians in Germany. Using testing stations that are situation-based, it will assess medical language competence and communication skills at the proficiency level of C1. Case scenarios for four mini-interviews of 10 minutes each were developed. For the written part of the exam, consisting of two separate testing stations with a combined duration of 40 minutes, one video of a physician taking a patient's history and one annotated set of laboratory results were developed. Based on the analysis of existing scientific literature as well as real-life examples, features and characteristics of professional medical language were identified. This served as the basis for the development of itemized rating scales for each of the testing stations. The exam was validated in three simulated trial runs. Each run was video-recorded and subsequently graded by a team of test-raters. 19 participants took part in the three trial runs. A benchmark (gold standard) could be set for 18 of these. A ROC-analysis yielded an AUC-value of .83. This confirmed the predictive quality of the SAM-test. The reliability of the SAM-test could be calculated for only ten participants. The internal consistency, calculated with the use of Cronbach's Alpha, was .85. The pass/fail mark was calculated based on the Youden-Index and yielded a result of >60%. The SAM-test presents a statistically valid medical language examination with a high level of objectivity. As required, it tests language proficiency at the level of C1 and uses authentic communication scenarios within a standardized test setting. Additional studies with larger test samples will help to further validate this test and thus guarantee a higher degree of reliability.
根据巴伐利亚州卫生部长第87次会议提出的要求，为巴伐利亚州开发一项科学合理且标准化的医学语言考试。这项考试（SAM，外国医生语言测试）应成为德国外国医生执照发放程序的一部分。通过使用基于情景的测试站，它将评估C1水平的医学语言能力和沟通技巧。开发了四个时长均为10分钟的迷你面试的病例场景。对于考试的笔试部分，由两个独立的测试站组成，总时长为40分钟，制作了一段医生采集患者病史的视频和一组带注释的实验室检查结果。基于对现有科学文献以及实际案例的分析，确定了专业医学语言的特点。这为每个测试站制定分项评分量表奠定了基础。该考试在三次模拟试运行中得到验证。每次试运行都进行了视频录制，随后由一组评分员进行评分。19名参与者参加了这三次试运行。其中18人可以设定一个基准（黄金标准）。ROC分析得出的AUC值为0.83。这证实了SAM测试的预测质量。SAM测试的可靠性仅能针对10名参与者进行计算。使用克朗巴哈系数计算得出的内部一致性为0.85。通过/未通过分数基于约登指数计算得出，结果为>60%。SAM测试是一项具有统计学有效性且客观性很高的医学语言考试。按照要求，它测试C1水平的语言能力，并在标准化测试环境中使用真实的交流场景。对更大测试样本进行的进一步研究将有助于进一步验证这项测试，从而保证更高的可靠性。
