Sutnick A I, Stillman P L, Norcini J J, Friedman M, Regan M B, Williams R G, Kachur E K, Haggerty M A, Wilson M P
Educational Commission for Foreign Medical Graduates, Philadelphia, PA 19104-2685.
JAMA. 1993 Sep 1;270(9):1041-5.
To develop an assessment of clinical competence of graduates of foreign medical schools and to determine the reliability and validity of the assessment and the feasibility of large-scale administration.
The Educational Commission for Foreign Medical Graduates (ECFMG) clinical competence study included (1) clinical encounters with standardized patients to assess history taking, physical examination, and communication skills; (2) laser videodisk pictorials to assess identification and interpretation of diagnostic procedures; (3) written clinical vignettes to assess diagnosis and management skills; and (4) assessment of spoken English. A uniform method of operating the test centers and of training the standardized patients was developed.
Medical schools and their primary teaching hospitals and affiliated hospitals.
Six hundred twenty-four first-year residents, of whom 525 are graduates of foreign medical schools.
Scores, reliability coefficients, validity measures, feasibility of multisite administration, trends of scores over time, and acceptability by examinees.
The ECFMG clinical competence assessment was conducted at four geographically separate test centers. Reliability coefficients were high (.85) for the integrated clinical encounter and were in a reasonable range (.71 to .82) for all test components. The assessment adds to the predictability of the residents' performance in the hospital over that of current ECFMG certification examinations. Test security was addressed by demonstrating no consistent pattern of change in scores over testing dates. Virtually all examinees thought the assessment was appropriate. Standardized patients were able to assess spoken English accurately.
The feasibility of conducting a reliable and valid test of clinical competence for graduates of foreign medical schools was demonstrated for this test population.
对外科医学院校毕业生的临床能力进行评估，并确定该评估的可靠性、有效性以及大规模实施的可行性。
外国医学毕业生教育委员会（ECFMG）临床能力研究包括：（1）与标准化病人进行临床接触，以评估病史采集、体格检查和沟通技巧；（2）使用激光视盘图像评估诊断程序的识别和解释能力；（3）书面临床病例评估诊断和管理技能；（4）英语口语评估。制定了统一的测试中心操作方法和标准化病人培训方法。
医学院校及其主要教学医院和附属医院。
624名一年级住院医师，其中525名是外国医学院校的毕业生。
分数、可靠性系数、有效性指标、多地点实施的可行性、分数随时间的变化趋势以及考生的可接受性。
ECFMG临床能力评估在四个地理位置分散的测试中心进行。综合临床接触的可靠性系数较高（0.85），所有测试组件的可靠性系数在合理范围内（0.71至0.82）。该评估增加了住院医师在医院表现的可预测性，超过了当前ECFMG认证考试。通过证明测试日期之间分数没有一致的变化模式来解决测试安全性问题。几乎所有考生都认为该评估是合适的。标准化病人能够准确评估英语口语。
对于该测试人群，证明了对外科医学院校毕业生进行可靠且有效的临床能力测试的可行性。
