Erlich Deborah
Tufts University School of Medicine.
PRiMER. 2017 Jul 20;1:7. doi: 10.22454/PRiMER.2017.626578. eCollection 2017 Sep.
A core principle of family medicine is information mastery, or application of principles of evidence-based medicine in clinical practice. While information mastery teaching and assessment are beginning to permeate postgraduate family medicine training programs, and while exciting literature on new open resource assessment methods is emerging, there are no prior descriptions of examinations that specifically assess medical students' information mastery competency.
To test information mastery competency, a novel final exam for the family medicine clerkship was developed, implemented, and evaluated. During the timed exam, the competency-based information mastery assessment (IMA) requires students to look up evidence-based information using web resources to answer case-based questions. Exam feasibility was tested with pilot examinees whose reactions were gauged. Student performance on the traditional closed book knowledge assessment (KA) was compared with performance on the open internet IMA. Exam performance was compared with preceptor ratings of students' clinical performance. Low performers were further analyzed for preceptors' ratings of specific student skills in information mastery and self-directed learning.
An open internet IMA testing knowledge application and information mastery skills is not only feasible but can also be educational. Student performance scores on the open internet IMA do not differ from scores on the closed book KA. Students describe many positive features of this open internet IMA. Student performance on the competency-based IMA correlates with clinical ratings by preceptors and with preceptors' judgment of information mastery skills.
A novel approach to assessment in family medicine clerkships may be used to assess student competency in information mastery. Further research is needed for enhanced exam validation.
家庭医学的一项核心原则是信息掌握，即在临床实践中应用循证医学原则。虽然信息掌握的教学与评估正开始渗透到研究生家庭医学培训项目中，并且关于新的开放资源评估方法的精彩文献也不断涌现，但此前尚无专门评估医学生信息掌握能力的考试描述。
为测试信息掌握能力，开发、实施并评估了一种新颖的家庭医学实习期末考。在限时考试中，基于能力的信息掌握评估（IMA）要求学生使用网络资源查找循证信息以回答基于病例的问题。对试点考生进行了考试可行性测试，并衡量了他们的反应。将学生在传统闭卷知识评估（KA）中的表现与在开放网络IMA中的表现进行比较。将考试成绩与带教老师对学生临床能力的评分进行比较。对表现不佳的学生进一步分析带教老师对其在信息掌握和自主学习方面特定技能的评分。
一项测试知识应用和信息掌握技能的开放网络IMA不仅可行，而且具有教育意义。学生在开放网络IMA上的成绩与闭卷KA的成绩没有差异。学生描述了这种开放网络IMA的许多积极特点。学生在基于能力的IMA上的表现与带教老师的临床评分以及带教老师对信息掌握技能方面的判断相关。
一种家庭医学实习评估的新方法可用于评估学生的信息掌握能力。需要进一步研究以加强考试的有效性验证。
