Department of Medical Education, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
Department of Mathematics and Statistics, The University of Toledo, Toledo, OH, USA.
BMC Med Educ. 2022 Nov 9;22(1):771. doi: 10.1186/s12909-022-03842-5.
One of the challenges in medical education is effectively assessing basic science knowledge retention. National Board of Medical Examiners (NBME) clerkship subject exam performance is reflective of the basic science knowledge accrued during preclinical education. The aim of this study was to determine if students' retention of basic science knowledge during the clerkship years can be analyzed using a cognitive diagnostic assessment (CDA) of the NBME subject exam data.
We acquired a customized NBME item analysis report of our institution's pediatric clerkship subject exams for the period of 2017-2020 and developed a question-by-content Q-matrix by identifying skills necessary to master content. As a pilot study, students' content mastery in 12 major basic science content areas was analyzed using a CDA model called DINA (deterministic input, noisy "and" gate).
The results allowed us to identify strong and weak basic science content areas for students in the pediatric clerkship. For example: "Reproductive systems" and "Skin and subcutaneous tissue" showed a student mastery of 83.8 ± 2.2% and 60.7 ± 3.2%, respectively.
Our pilot study demonstrates how this new technique can be applicable in quantitatively measuring students' basic science knowledge retention during any clerkship. Combined data from all the clerkships will allow comparisons of specific content areas and identification of individual variations between different clerkships. In addition, the same technique can be used to analyze internal assessments thereby creating an opportunity for the longitudinal tracking of student performances. Detailed analyses like this can guide specific curricular changes and drive continuous quality improvement in the undergraduate medical school curriculum.
医学教育的挑战之一是有效地评估基础科学知识的保留情况。全国医师执照考试（NBME）实习科目考试成绩反映了临床前教育期间获得的基础科学知识。本研究旨在确定是否可以使用 NBME 科目考试数据的认知诊断评估（CDA）来分析实习期间学生对基础科学知识的保留情况。
我们获取了我们机构儿科实习科目考试的定制化 NBME 项目分析报告，并通过确定掌握内容所需的技能来制定问题-内容 Q 矩阵。作为试点研究，我们使用称为 DINA（确定性输入，嘈杂“与”门）的 CDA 模型分析了 12 个主要基础科学内容领域中学生的内容掌握情况。
结果使我们能够确定儿科实习中学生的基础科学内容的强项和弱项。例如：“生殖系统”和“皮肤和皮下组织”的学生掌握程度分别为 83.8±2.2%和 60.7±3.2%。
我们的试点研究表明，这种新技术如何能够在定量测量学生在任何实习期间的基础科学知识保留情况方面具有适用性。所有实习科目的综合数据将允许比较特定内容领域，并确定不同实习之间的个体差异。此外，还可以使用相同的技术来分析内部评估，从而为学生表现的纵向跟踪创造机会。这样的详细分析可以指导特定的课程改革，并推动本科医学院校课程的持续质量改进。
