医学生临床能力的测评与分析 ─ 七年制临床医学生临床技能考核的概化理论研究

The Evaluation and Analysis of the Clinical Competence of the Medical Students：Using Multivariate Generalizability Theory in Clinical Skill Assessment of Internal Medicine in 7 ─ year Medical Students before Graduated

为了科学、客观地评价七年制临床医学生的临床技能，我们应用新的教育测量理论 ─ 多元概化理论，对七年制床医学生毕业前的内科临床技能考核结果进行分析研究。结果表明，临床技能考核总的可靠性指数为0.63725，绝对信噪比为1.75668，提示本次临床技能考核总的信度符合考核要求；临床思维能力和理论知识水平部分内容信度相对较高，也较能有效区分考生能力的差别，临床实践能力的信度较低；评分者素质与评分能力相对较好。多元概化理论能客观、科学地评价七年制医学毕业生临床技能考核，其分析结果对于提高及改进临床技能考核质量有较大帮助。

To accurately assess the clinical skill of medical students， we analyzed clinical skill tests of internal medicine in 23 7─year medical students before the would graduated from medical school by using a new educational measurement theory ─ multivariate generalizability theory. The results show that the dependability index calculated for this test from generalizability study was 0.63725. It suggested that the reliability of this test was high. The score of one student can reflect his clinical skill. Furthermore， we also could conclude that change the condition of each facets（item or rater） should obtain different dependability index by the decision study. So we can improve our test reliability such as change the content of test according the result of D─study. Conclusion：multiple generalizability theory is very useful tool to assess the clinical skill of 7 ─ year medical students.