我国临床类别医师资格考试实践技能考试基地评价指标体系构建与思考

doi:10.3760/cma.j.cn115259-20260326-00407

中华医学教育杂志 ›› 2026, Vol. 46 ›› Issue (10): 789-795.DOI: 10.3760/cma.j.cn115259-20260326-00407

我国临床类别医师资格考试实践技能考试基地评价指标体系构建与思考

武欣宇¹, 张颖², 温吉元³, 丁一民², 张文娟², 江哲涵⁴

¹北京大学公共卫生学院卫生政策与管理学系2023级公共卫生专业硕士研究生,北京 100191;
²国家医学考试中心考务管理部,北京 100097;
³国家医学考试中心发展研究部,北京 100097;
⁴北京大学医学教育研究所,北京 100191

收稿日期:2026-03-26 出版日期:2026-10-01 发布日期:2026-09-30
通讯作者: 江哲涵, Email: jiangzhehan@bjmu.edu.cn
基金资助:
2024年国家自然科学基金面上项目(72474004);2026年国家医学考试中心创新性研究型项目(2026-03-17)

Construction and reflections of an evaluation indicator system for clinical skills examination bases of the qualification examination for clinical category physicians in China

Wu Xinyu¹, Zhang Ying², Wen Jiyuan³, Ding Yimin², Zhang Wenjuan², Jiang Zhehan⁴

¹Master of Public Health Candidate, Department of Health Policy and Management, Enrolled in 2023, School of Public Health, Peking University, Beijing 100191, China;
²Department of Examination Affairs Management, National Medical Examination Center, Beijing 100097, China;
³Department of Development and Research, National Medical Examination Center, Beijing 100097, China;
⁴Institute of Medical Education, Peking University, Beijing 100191, China

Received:2026-03-26 Online:2026-10-01 Published:2026-09-30
Contact: Jiang Zhehan, Email: jiangzhehan@bjmu.edu.cn
Supported by:
2024 General Program of the National Natural Science Foundation of China (72474004);2026 Innovative Research Project of the National Medical Examination Center (2026-03-17)

摘要/Abstract

摘要： 目的构建科学、系统、可操作的我国临床类别医师资格考试实践技能考试基地评价指标体系,探索其构建方法与理论依据,为考试基地的标准化建设与质量改进提供参考。方法综合运用文献分析法和半结构化访谈法构建初始指标池,基于决策导向模式和利益相关者理论确立指标框架,于2025年12月至2026年2月依托国家医学考试中心遴选16名熟悉考试基地建设与运行的专家,开展2轮德尔菲法咨询进行指标筛选和修订,采用层次分析法确定各级指标权重。选取我国东部、中部、西部7个代表性的临床类别医师资格考试实践技能考试基地进行实证评价。结果 2轮专家咨询均回收16份有效问卷,专家权威系数均为0.944(专家判断依据为0.950,熟悉程度为0.938),第一轮协调系数为0.378~0.392(均P<0.05),第二轮协调系数为0.416~0.450(均P < 0.001),专家意见协调程度良好。最终构建的评价指标体系包括基础保障、过程质量、最终产出3个一级指标和10个二级指标、33个三级指标。一级指标中“过程质量”权重最高、“基础保障”权重次之、“最终产出”相对较低。7个临床类别实践技能考试基地综合评分介于71.59~93.61分,各临床类别实践技能考试基地的综合评分差异较大。结论本研究构建的临床类别医师资格考试实践技能考试基地评价指标体系理论基础扎实、方法科学、专家认可度高,可以为临床类别医师资格考试实践技能考试基地的标准化建设和质量改进提供有效工具,其构建方法具有较好的实践应用价值与政策参考意义。

关键词: 评价研究, 医师资格考试, 实践技能考试基地, 评价指标体系

Abstract: Objective To develop a scientific, systematic, and operational evaluation indicator system for clinical skills examination bases of the qualification examination for clinical category physicians in China, to explore its construction methodology and theoretical basis, and to inform the standardized construction and quality improvement. Methods An initial indicator pool was constructed through literature review and semi-structured interviews. Based on the Context-Input-Process-Product model and stakeholder theory, an indicator framework was established. From December 2025 to February 2026, 16 experts familiar with the construction and operation of clinical skills examination bases were selected through purposive sampling in collaboration with the National Medical Examination Center. Two rounds of Delphi consultation were conducted for indicator screening and revision, and the Analytic Hierarchy Process was employed to determine indicator weights at all levels. Seven representative bases from eastern, central, and western China were selected for empirical evaluation. Results Both rounds of expert consultation yielded 16 valid questionnaires. The expert authority coefficient was 0.944 (judgment basis: 0.950, familiarity: 0.938). The Kendall′s coefficients of concordance for the first round ranged from 0.378 to 0.392 (all P<0.05), and for the second round from 0.416 to 0.450 (all P<0.001), indicating good expert consensus. The final evaluation indicator system comprised three primary indicators (Basic Support, Process Quality, and Final Outputs), ten secondary indicators, and 33 tertiary indicators. Among the primary indicators, Process Quality had the highest weight, followed by Basic Support and Final Outputs. The comprehensive scores of the seven clinical skills examination bases ranged from 71.59 to 93.61, showing significant differences among bases. Conclusions The evaluation indicator system for clinical skills examination bases of the qualification examination for clinical category physicians developed in this study has a solid theoretical foundation, scientific methodology, and high expert recognition. It can serve as an effective tool for the standardized construction and quality improvement of examination bases, and its construction methodology has good practical application value and policy implications.

Key words: Evaluation studies, Physician qualification examination, Clinical skills examination bases, Evaluation indicator system

中图分类号:

R-05

武欣宇, 张颖, 温吉元, 丁一民, 张文娟, 江哲涵. 我国临床类别医师资格考试实践技能考试基地评价指标体系构建与思考[J]. 中华医学教育杂志, 2026, 46(10): 789-795, DOI: 10.3760/cma.j.cn115259-20260326-00407.

Wu Xinyu, Zhang Ying, Wen Jiyuan, Ding Yimin, Zhang Wenjuan, Jiang Zhehan. Construction and reflections of an evaluation indicator system for clinical skills examination bases of the qualification examination for clinical category physicians in China[J]. Chinese Journal of Medical Education, 2026, 46(10): 789-795, DOI: 10.3760/cma.j.cn115259-20260326-00407.

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我国临床类别医师资格考试实践技能考试基地评价指标体系构建与思考

Construction and reflections of an evaluation indicator system for clinical skills examination bases of the qualification examination for clinical category physicians in China

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