Hemmer P A, Pangaro L
74th Medical Group, Wright-Patterson Air Force Base, Ohio 45433-5529, USA.
Acad Med. 1997 Jul;72(7):641-3. doi: 10.1097/00001888-199707000-00018.
To compare evaluation methods for identifying third-year medical students whose funds of knowledge are marginal.
The written evaluation forms and comments from a formal evaluation session for 124 students in the inpatient medicine clerkship in 1992-93 at the Uniformed Services University of the Health Sciences F. Edward Hébert School of Medicine were reviewed. The written and verbal ratings of a student's general fund of knowledge were converted to similar five-point categorical scales. For each evaluation method, chi-square analysis was used to compare the students identified as having marginal funds of knowledge with those who scored < or = 300 on the end-of-clerkship NBME subject examination.
Sixteen students scored < or = 300 on the NBME subject examination. For the checklist descriptors, ratings of "marginal" identified three of these 16 students (a sensitivity of 19%). For the written comments on the evaluation form, ratings of "marginal" identified four of the 16 (a sensitivity of 25%). For the formal evaluation session, however, ratings of "marginal" identified seven of the 16 (a sensitivity of 44%). The specificity of a "marginal" rating was excellent (> or = 95%) for all three evaluation methods. Chi-square analysis was significant for each method (p < or = .01).
Although the ability of housestaff and faculty to identify students with weak funds of knowledge may be less than ideal, it may be improved by the routine use of a formal evaluation session. If done during the clerkship, this would allow for a specific plan of remediation to be designed with the instructors for the students at risk.
比较识别医学三年级学生知识储备薄弱的评估方法。
回顾了1992 - 1993年在健康科学统一服务大学F.爱德华·赫伯特医学院内科实习的124名学生的正式评估会议的书面评估表和评语。将学生知识储备的书面和口头评分转换为类似的五点分类量表。对于每种评估方法，使用卡方分析比较被确定为知识储备薄弱的学生与在实习结束时美国国家医学考试委员会（NBME）科目考试中得分≤300分的学生。
16名学生在NBME科目考试中得分≤300分。对于清单描述符，“薄弱”评级识别出这16名学生中的3名（敏感性为19%）。对于评估表上的书面评语，“薄弱”评级识别出16名中的4名（敏感性为25%）。然而，对于正式评估会议，“薄弱”评级识别出16名中的7名（敏感性为44%）。对于所有三种评估方法，“薄弱”评级的特异性都非常好（≥95%）。每种方法的卡方分析均具有显著性（p≤0.01）。
虽然住院医师和教师识别知识储备薄弱学生的能力可能不尽人意，但通过常规使用正式评估会议可能会有所改善。如果在实习期间进行，这将允许为有风险的学生与教师设计具体的补救计划。
