Newble D I, Hoare J, Elmslie R G
Med Educ. 1981 Jan;15(1):46-52. doi: 10.1111/j.1365-2923.1981.tb02315.x.
In a previous study we described a problem-based criterion-referenced test of the clinical competence of medical students which was felt to offer advantages over the traditional final-year examination. This paper reports the validity and reliability studies on which it is possible to judge the value of this new test when compared to the traditional approach. The results demonstrate a high level of content validity and provide evidence of the construct validity of the test. Efforts to obtain measures of concurrent and predictive validity were thwarted by a failure to attain reliable assessments of ward performance from resident and consultant staff. Satisfactory levels of internal consistency were established for the whole test. Marker reliability was satisfactory in all sections of the test except for those requiring examiners to rate practical clinical skills. This was so despite the use of simulated patients, behavioural check-lists and rater training. Possible solutions to this problem are discussed. It is concluded that this new approach overcomes many of the measurement problems inherent in the traditional final examination. It has been shown to be feasible to construct and administer in the medical school setting without the need for the allocation of additional resources.
在之前的一项研究中，我们描述了一种基于问题的医学专业学生临床能力标准参照测试，该测试被认为比传统的毕业考试具有优势。本文报告了效度和信度研究，通过这些研究可以判断与传统方法相比，这种新测试的价值。结果显示出较高的内容效度，并为该测试的结构效度提供了证据。由于未能从住院医师和顾问人员那里获得对病房表现的可靠评估，因此获取同时效度和预测效度测量值的努力受到了阻碍。整个测试建立了令人满意的内部一致性水平。除了要求考官对实际临床技能进行评分的部分外，测试所有部分的评分者信度都令人满意。尽管使用了模拟患者、行为检查表和评分者培训，但情况仍然如此。讨论了该问题可能的解决方案。结论是，这种新方法克服了传统期末考试中固有的许多测量问题。已经证明，在医学院环境中构建和实施该测试是可行的，无需额外分配资源。
