Sun Jie, Xie Yingying, Zhang Ningnannan, Cheng Jingliang, Wang Meiyun, Zhang Bing, Zhu Wenzhen, Zhang Hui, Qiu Shijun, Xu Xiaojun, Yu Yongqiang, Han Tong, Geng Zuojun, Liao Weihua, Gao Bo, Qin Wen, Liu Feng, Liang Meng, Xu Qiang, Fu Jilian, Xu Jiayuan, Liu Mengge, Zhang Peng, Li Wei, Shi Dapeng, Wang Caihong, Zuo Xi-Nian, Zhang Quan, Chen Feng, Li Jiance, Yan Zhihan, Shen Wen, Miao Yanwei, Xian Junfang, Zhang Longjiang, Xu Kai, Ye Zhaoxiang, Zhang Jing, Cui Guangbin, Yu Chunshui
Department of Radiology and Tianjin Key Lab of Functional Imaging and Tianjin Institute of Radiology and State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, 300052, China.
Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian, China.
BMC Med Educ. 2025 Jan 14;25(1):65. doi: 10.1186/s12909-025-06652-7.
National Medical Licensing Examination (NMLE) is the entrance exam for medical practice in China, and its general medical knowledge test (GMKT) evaluates abilities of medical students to comprehensively apply medical knowledge to clinical practice. This study aimed to identify nonacademic predictors of GMKT performance, which would benefit medical schools in designing appropriate strategies and techniques to facilitate the transition from medical students to qualified medical practitioners.
In 1202 medical students, we conducted the deletion-substitution-addition (DSA) and structural equation model (SEM) analyses to identify nonacademic predictors of GMKT performance from 98 candidate variables including early life events, physical conditions, psychological and personality assessments, cognitive abilities, and socioeconomic conditions. The candidate variables were assessed using psychometrically or cognitively validated and accepted instruments.
We identified seven nonacademic predictors for GMKT performance. Body mass index (BMI) and working memory reaction time showed direct negative effects on GMKT performance. Psychological and personality features (conscientiousness, state anxiety, and openness to experience) indirectly affected GMKT performance via BMI, while socioeconomic conditions (father's education and mother's occupation) indirectly affected GMKT performance by influencing psychological and personality features and further BMI.
The identified nonacademic predictors for GMKT performance and their pathways may be useful for improving medical education by strengthening favorable and weakening, rectifying, or compensating unfavorable factors that are modifiable.
国家医师资格考试是中国医疗执业的入门考试，其医学综合知识测试（GMKT）评估医学生将医学知识综合应用于临床实践的能力。本研究旨在确定GMKT成绩的非学术预测因素，这将有助于医学院校设计合适的策略和技术，以促进医学生向合格执业医师的转变。
在1202名医学生中，我们进行了删除-替换-添加（DSA）和结构方程模型（SEM）分析，以从98个候选变量中确定GMKT成绩的非学术预测因素，这些变量包括早期生活事件、身体状况、心理和个性评估、认知能力以及社会经济状况。使用经过心理测量或认知验证且被接受的工具对候选变量进行评估。
我们确定了GMKT成绩的七个非学术预测因素。体重指数（BMI）和工作记忆反应时间对GMKT成绩有直接负面影响。心理和个性特征（尽责性、状态焦虑和经验开放性）通过BMI间接影响GMKT成绩，而社会经济状况（父亲的教育程度和母亲的职业）通过影响心理和个性特征进而影响BMI，间接影响GMKT成绩。
所确定的GMKT成绩的非学术预测因素及其途径可能有助于通过强化有利因素、削弱、纠正或补偿可改变的不利因素来改进医学教育。
