住院医师客观结构化临床考试中运用多元概化理论的探索与实践

Exploration and Practice on Multivariate Generalizability Theory in Objective Structured Clinical Examination for Resident Training

目的探索科学客观评价住院医师规范化培训中临床实践技能的考核办法。方法对北京协和医院放射科住院医师规范化培训临床技能进行客观结构化临床考试(objective structured clinical examination,OSCE),采用多元概化理论对考试成绩进行方差分析、D研究和G研究。结果本次OSCE总的相对概化系数为0.917,绝对概化系数为0.912,本次考核信度较高。考试站点增加为6站可以提高考试信度,相对概化系数提高至0.976。结论多元概化理论能科学客观地评价住院医师OSCE临床技能考核结果。

Objective To explore the scientific and objective assessment methods for evaluating the clini-cal practice skills of residents undergoing standardized training. Methods Multivariate generalizability theory was used to analyze the scores of objective structured clinical examination （OSCE） of clinical skills of trainees in Departmentof Radiology in Peking Union Medical College Hospital by analysis of variance, D analysis and G analy-sis. Results The total relative generalizability coefficient of OSCE was 0. 917, and the absolute generalizability coefficient was 0. 912,which showed that the reliability of this assessment was higher. Test site increased to 6 sta-tions which would greatly improve the test reliability,the relative generalizability coefficient increased to 0. 976. Conclusions Multivariate generalizability theory is an objective and scientific tool to evaluate the OSCE stations, and the analysis results are helpful to improve the practice for future OSCE.