Hamamoto Filho Pedro Tadao, Hashimoto Miriam, Lima Alba Regina de Abreu, Diehl Leandro Arthur, Costa Neide Tomimura, Rehder Patrícia Moretti, Yarak Samira, Andrade Maria Cristina de, Hafner Maria de Lourdes Marmorato Botta, Ribeiro Zilda Maria Tosta, Moriguti Júlio César, Bicudo Angélica Maria
Physician, Assistant Professor, Departament of Pediatrics, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), Botucatu (SP), Brazil.
Biologist, Assistant Professor, Departament of Molecular Biology, Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto (SP), Brazil.
Sao Paulo Med J. 2024 Jul 15;142(6):e2023291. doi: 10.1590/1516-3180.2023.0291.R1.13052024. eCollection 2024.
Brazilian medical schools equitably divide their medical education assessments into five content areas: internal medicine, surgery, pediatrics, obstetrics and gynecology, and public health. However, this division does not follow international patterns and may threaten the examinations' reliability and validity.
To assess the reliability indices of the content areas of serial, cross-institutional progress test examinations.
This was an analytical, observational, and cross-sectional study conducted at nine public medical schools (mainly from the state of São Paulo) with progress test examinations conducted between 2017 and 2023.
The examinations covered the areas of basic sciences, internal medicine, surgery, pediatrics, obstetrics and gynecology, and public health. We calculated reliability indices using Cronbach's α, which indicates the internal consistency of a test. We used simple linear regressions to analyze temporal trends.
The results showed that the Cronbach's α for basic sciences and internal medicine presented lower values, whereas gynecology, obstetrics, and public health presented higher values. After changes in the number of items and the exclusion of basic sciences as a separate content area, internal medicine ranked highest in 2023. Individually, all content areas except pediatrics remained stable over time.
Maintaining an equitable division in assessment content may lead to suboptimal results in terms of assessment reliability, especially for internal medicine. Therefore, content sampling of medical knowledge for general assessments should be reappraised.
巴西医学院将其医学教育评估公平地划分为五个内容领域：内科、外科、儿科、妇产科和公共卫生。然而，这种划分并不遵循国际模式，可能会威胁到考试的可靠性和有效性。
评估系列跨机构进展测试考试内容领域的可靠性指标。
这是一项分析性、观察性横断面研究，在九所公立医学院（主要来自圣保罗州）进行，进展测试考试于2017年至2023年期间进行。
考试涵盖基础科学、内科、外科、儿科、妇产科和公共卫生领域。我们使用Cronbach's α计算可靠性指标，该指标表明测试的内部一致性。我们使用简单线性回归分析时间趋势。
结果显示，基础科学和内科的Cronbach's α值较低，而妇科、产科和公共卫生的Cronbach's α值较高。在项目数量发生变化并将基础科学作为一个单独的内容领域排除后，内科在2023年排名最高。单独来看，除儿科外的所有内容领域随时间保持稳定。
在评估内容上保持公平划分可能会导致评估可靠性方面的次优结果，尤其是在内科方面。因此，应重新评估用于一般评估的医学知识内容抽样。
