临床医学本科培养中设置临床课程综合考试的实践探讨  

The Practice of the Clinical Courses Comprehensive Examination in Cultivation for Clinical Medicine Undergraduates

作　　者：程祺峻 翟建才 宋桐林 梅林 黄春基 CHENG Qijun;ZHAI Jiancai;SONG Tonglin;MEI Lin;HUANG Chunji(Examination Management and Teaching Evaluation Center,Army Medical University,Chongqing 400030,China;Department of Academic and Scientific Research,Army Medical University,Chongqing 400030,China)

机构地区：[1]陆军军医大学教学考评中心,重庆400030 [2]陆军军医大学科研学术处,重庆400030

出　　处：《中国继续医学教育》2022年第1期9-14,共6页China Continuing Medical Education

基　　金：重庆市高等教育教学改革研究项目(19058);中华医学会医学教育分会和中国高等教育学会医学教育专业委员会医学教育研究课题(2018B-N03070)。

摘　　要：目的分析我校设置临床课程综合考试的实践成效,发现存在的问题,提出改进建议,为医学院校设置临床医学综合考试提供参考。方法收集2007—2019年临床课程综合考试和国家执业医师考试医学综合笔试成绩,运用趋势卡方检验分析历年考试成绩变化。通过雷达图和t检验分析综合考试各课程和单科期末考试成绩的差异。结果历年临床课程综合考试平均成绩不存在线性趋势,差异无统计学意义(P=0.376);实施综合考试后,学生在国家执业医师考试医学综合笔试通过率及临床医学部分掌握率均有线性递增趋势,差异有统计学意义(P<0.05)。综合考试各课程得分和单科期末考试得分差异无统计学意义(P>0.05);雷达图显示学生临床课程整体学习效果一般,各课程表现相差较小。结论临床课程综合考试有益于提升学生知识综合应用能力和发现临床教学中的问题,学校应继续完善考试设计,紧贴医学教育改革趋势,注重知识融合和实际应用,同时也应科学设置题型题量,明确考核结果应用,严把试题质量关,以提升考试效果。Objective To provide reference for medical colleges to set clinical courses comprehensive examination by analyzing the practice effect of a university.Methods Analyzing grades of clinical courses comprehensive examination and National Medical Licensing Examination during 2007 and 2019 via Trend chi square test.We used Radar graph and t-test to identify the difference in grades of each course in comprehensive examination and final examination.Results There is no linear trend in the average score of comprehensive examination of clinical courses over the years.There was no significant difference(P=0.376);after the implementation of the comprehensive examination,there was a linear increasing trend in the passing rate of the comprehensive written medical examination and the mastery rate of clinical medicine of the students in the national medical practitioner examination(P<0.05).There was no significant difference in the scores of each course of the comprehensive examination and the final examination of a single subject(P>0.05);the radar chart shows that the overall learning effect of students'clinical courses is general,and the performance difference of each course is small.Conclusion Clinical courses comprehensive examination had a positive effect on improving students'comprehensive ability of knowledge application and teaching feedback.When we design the examination,we better pay attention to the content of questions which should follow the development trend of medical education reform and focus on knowledge fusion and application.Besides,setting up quantity of questions scientifically,clearing the application of test results and strict quality control were also ways to improve the examination effect.

关 键 词：临床课程综合考试 成绩分析 临床教学 课程整合 人才培养质量 教学改革 

分 类 号：G642[文化科学—高等教育学]