Norman G R, Tugwell P, Feightner J W, Muzzin L J, Jacoby L L
Med Educ. 1985 Sep;19(5):344-56. doi: 10.1111/j.1365-2923.1985.tb01336.x.
A consistent finding in the literature on measures of clinical problem-solving scores is that there are very low correlations across different problems. This phenomenon is commonly labelled 'content-specificity', implying that the scores differ because the content knowledge necessary to solve the problems differs. The present study tests this hypothesis by presenting groups of residents and clinical clerks with a series of simulated patient problems in which content was systematically varied. Each subject also completed a multiple choice test with questions linked to each diagnosis presented in the clinical problems. Three of the four problem-solving scores showed low correlations, even to two presentations of the same problem, and no relationship to content differences. None of the scores were related to performance on the multiple choice test. The results suggest that variability in problem-solving scores is related to factors other than content knowledge, and several possibilities are discussed.
关于临床问题解决分数测量的文献中一个一致的发现是，不同问题之间的相关性非常低。这种现象通常被标记为“内容特异性”，这意味着分数不同是因为解决问题所需的内容知识不同。本研究通过向住院医师和临床实习生群体呈现一系列模拟患者问题来检验这一假设，其中内容是系统变化的。每个受试者还完成了一项多项选择题测试，题目与临床问题中给出的每个诊断相关。四个问题解决分数中的三个显示出低相关性，甚至对于同一问题的两种呈现方式也是如此，并且与内容差异无关。没有一个分数与多项选择题测试的表现相关。结果表明，问题解决分数的变异性与内容知识以外的因素有关，并讨论了几种可能性。
