紧急医学救援培训结业考试质量分析

Quality Analysis of Objective Structured Clinical Examination in Emergency Medical Rescue Training

目的分析紧急医疗救援培训结业考试——客观结构化临床考试(OSCE)的考试质量,对考试结果做出准确解释,建立规范化、标准化的紧急医疗救援培训考核方法。方法组织9位临床专家和教师设计并制订了10站的OSCE。33名国家级紧急医学救援队队员按培训大纲培训结束后,用这种OSCE进行操作技能结业考核。采用扩展的Angoff法,计算分界组分数(合格分数),运用SPSS19.0录入数据,描述性统计了考试成绩分布情况,分析计算了考试难度、区分度、Cronbach系数的α值和内容效度等指标。结果考试平均分为72.3±7.1分,成绩基本符合正态分布。考试的整体难度系数为0.723,信度分析Cronbach系数α值为0.941,OSCE成绩与平时成绩的相关系数为0.899。每个考站的难度在0.48至0.83之间、区分度在0.11至0.89。分界组分数的为63.2,其中合格30人、不合格3人。结论设计和实施的OSCE结构合理,具有良好的区分度、信度和效度,考试结果真实可信,客观评价了国家级紧急医学救援队队员的能力水平,可作为卫生应急工作培训的考核方式。运用扩展的Angoff法确定合格标准准确地解释了考试结果,为国家级紧急医学救援队科学组训和考核提供了有效参考。

Objective To analyze the quality of Objective Structured Clinical Examination（OSCE） which applied to emergency medical rescue training as the final exam, and correctly interpret test scores so as to promote the disaster training and evaluation. Methods The OSCE which includes 10 examination stations is set by the discussion of 9 professional clinical experts and teachers. After ending the training program, a total of 33 medical rescue team members are tested by an OSCE specially designed as their final exam. SPSS19.0 is used for data entry and statistic analysis. The details of the analysis include statistical description of the team members＇ scores, and the index of difficulty level and discrimination of the exam, α value of Cronbach＇ s coefficient, and content-related validity coefficient , etc. are calculated and analyzed. Results The average score of OSCE is 72.3 ± 7.1, and conforms to the normal distribution basically. The overall difficulty coefficient is 0. 723, reliability analysis of a value of Cronbach＇ s coefficient is 0.941, criterion-related validity coefficient is 0. 899. The difficulty level of every examination station is between 0.48 and 0.83, discrimination degree is between 0.11 and 0.89. The cut-off score is 63.2, the number of the passers is 30, and 3 examinees are unqualified. Conclusions The analysis results of the OSCE quality evaluation indexes show its appropriate distinction, good reliability and validity. The OSCE exam results objectively evaluate the real composite performance of the medical rescue team members, and can be applied to be an effective evaluation method for emergency rescue training. Applying Angoff＇ s extended approach to determine the eligible criteria can correctly interpret test scores. The OSCE can provide effective reference and evaluation for scientific training of national emergency medical rescue teams .