医学教育评价的演进及各阶段特征

doi:10.3760/cma.j.cn115259-20240906-00930

摘要/Abstract

摘要： 医学教育评价历经学习评价-以评促学-学评融合3个阶段,各阶段评价的关注点分别为终结性评价、形成性评价和程序性评价,并由此出现评价模式和内涵的不断演变。评价目的从判别学习者合格与否的教育测量,转为增加评价的教育效能和催化作用,进而将多种评价方式整合起来,系统评价学习者的核心胜任力。医学教育有必要与时俱进,借助人工智能的发展潮流,逐步改进教育评价的方式与实践,加速胜任力导向医学教育的落实与发展。

关键词: 学习评价, 以评促学, 学评融合, 程序性评价

Abstract: Medical education assessment has gone through three stages: assessment of learning, assessment for learning, and assessment as learning. The focus of evaluation in each stage is respectively summative assessment, formative assessment, and programmatic assessment, which has led to the continuous evolution of evaluation models and connotations. The purpose of assessment has shifted from educational measurement to determine whether learners are qualified, to increasing educational effect and catalytic effect of assessment, and then integrating multiple assessment methods to systematically evaluate learners′ core competencies. It is necessary for medical education to keep up with the times and take advantage of the trend of artificial intelligence development to gradually improve the methods and practices of educational assessment, and accelerate the implementation and development of competency-based medical education.

Key words: Assessment of learning, Assessment for learning, Assessment as learning, Programmatic assessment

中图分类号:

R-05

齐心. 医学教育评价的演进及各阶段特征[J]. 中华医学教育杂志, 2025, 45(5): 332-337.

Qi Xin. The evolution and characteristic of medical education assessment[J]. Chinese Journal of Medical Education, 2025, 45(5): 332-337.

参考文献

[1] Ross S, Hauer KE, Wycliffe-JonesK,et al. Key considerations in planning and designing programmatic assessment in competency-based medical education[J]. Med Teach, 2021, 43(7): 758-764. DOI:10.1080/0142159X.2021.1925099.
[2] Schuwirth LWT, Vleuten CPM.A history of assessment in medical education[J]. Adv Health Sci Educ Theory Pract, 2020, 25(5):1045-1056. DOI:10.1007/s10459-020-10003-0.
[3] KibbleJD.Best practices in summative assessment[J]. Adv Physiol Educ, 2017, 41(1):110-119. DOI:10.1152/advan.00116.2016.
[4] Norcini J, Anderson MB,Bollela V, et al. 2018 Consensus framework for good assessment[J]. Med Teach, 2018, 40(11): 1102-1109. DOI: 10.1080/0142159X.2018.1500016.
[5] EvaKW.On the generality of specificity.[J]. Med Educ, 2010, 37(7):587-588. DOI:10.1046/j.1365-2923.2003.01563.x.
[6] Norman G R, Vleuten CPM, GraaffED.Pitfalls in the pursuit of objectivity: issues of validity, efficiency and acceptability[J].Med Educ, 2010, 25(2) :119-26. DOI:10.1111/j.1365-2923.1991.tb00037.x.
[7] 齐心. 置信职业行为的演进、内涵与实践[J]. 中华医学教育探索杂志,2024,23(9):1153-1160. DOI:10.3760/cma.j.cn116021-20240201-01830.
[8] 冯攀. 美国医师执照考试临床技能考试停考的启示[J]. 中华医学教育杂志,2022,42(3):285-288. DOI:10.3760/cma.j.cn115259-20210902-01105.
[9] 王辰. 构建新时代国家医学教育与研究体系[N/OL]. (2021-03-08)[2023-03-10].http://www.moe.gov.cn/jyb_xwfb/xw_zt/moe_357/2021/2021_zt01/lianzuhui/lianzuhuii_fayan/202103/t20210308_518458.html.
[10] Bloomberg PJ, Vandas K, Twyman I, et al. Amplify learner voice through culturally responsive and sustaining assessment [M]. San Diego, CA: Mimi & Todd Press,2022:38,46-49.
[11] 曹飞. 形成性评价前沿动向及借鉴[J]. 湖南师范大学教育科学学报,2024,23(2):87-96,116. DOI:10.19503/j.cnki.1671-6124.2024.02.011.
[12] Sadler DR.Formative assessment and the design of instructional systems[J]. Instr Sci, 1989, 18(2):119-144.DOI:10.1007/BF00117714.
[13] Prashanti E,Ramnarayan K.Ten maxims of formative assessment[J]. Adv Physiol Educ, 2019, 43(2):99-102.DOI:10.1152/advan.00173.2018.
[14] 齐心,余更生,向阳,等. 《住院医师规范化培训操作技能直接观察评估指南(2022年版)》解读[J]. 中国毕业后医学教育,2023,7(1):29-33. DOI:10.3969/j.issn.2096-4293.2023.01.006.
[15] Abdulnour REE, Parsons AS, MullerD,et al. Deliberate practice at the virtual bedside to improve clinical reasoning[J]. N Engl J Med, 2022, 386(20):1946-1947. DOI:10.1056/NEJMe2204540.
[16] 齐建光. 探讨形成性评价与住院医师自主学习能力的培养[J]. 毕业后医学教育,2020,4(1):33-36. DOI:10.3969/j.issn.2096-4293.2020.01.009.
[17] Lefroy J, Watling C,Teunissen PW,et al.Guidelines: the do′s, don′ts and don′t knows of feedback for clinical education[J]. Perspect Med Educ, 2015, 4(6):284-299. DOI:10.1007/s40037-015-0231-7.
[18] Van Melle E, Frank JR, Holmboe ES, et al. Acore components framework for evaluating implementation of competency-based medical education programs[J]. Acad Med, 2019,94(7):1002-1009. DOI: 10.1097/ACM.0000000000002743.
[19] Heeneman S, Jong LHD, Dawson LJ,et al.Ottawa 2020 consensus statement for programmatic assessment-1. agreement on the principles[J]. Med Teach,2021,43(10):1139-1148.DOI:10.1080/0142159X.2021.1957088.
[20] Torre D, Rice NE, RyanA ,et al.Ottawa 2020 consensus statements for programmatic assessment 2: implementation and practice[J]. Med Teach, 2021,43(10):1149-1160. DOI:10.1080/0142159X.2021.1956681.
[21] 齐心,闫辉,齐建光,等. 程序性评价在胜任力导向医学教育中的作用[J]. 医学与社会,2023,36(6):140-144. DOI:10.13723/j.yxysh.2023.06.025.
[22] Edgar L, Jones MD,Harsy B,et al.Better decision-making: shared mental models and the clinical competency committee[J].J Grad Med Educ, 2021, 13(2 Suppl):51-58.DOI:10.4300/JGME-D-20-00850.1.
[23] Oswald A, Dubois D, Snell L, et al. Implementingcompetence committees on a national scale: design and lessons learned[J]. Perspect Med Educ,2024, 13(1):56-67. DOI: 10.5334/pme.961.
[24] Pack R, Lingard L, WatlingC,et al. Beyond summative decision making: illuminating the broader roles of competence committees[J].Med Educ, 2020, 54(6): 517-527.DOI:10.1111/medu.14072.
[25] Masters K, MacNeil H, Benjamin J, et al. Artificial Intelligence in Health Professions Education assessment: AMEE Guide No. 178. Med Teach, 2025, 9:1-15. DOI: 10.1080/0142159X.2024.2445037.