2021年1月,美国医师执照考试主办方决定停止第二步临床技能考试。该考试在医师能力评价中发挥过关键作用,曾经是医师临床技能评价考试的样板。新冠肺炎疫情影响是停考的直接因素,但该考试在考试成本、内容效度和评价反馈等方面存在的不足也是导致考试运行困难的重要原因。停考政策给医学院校教育带来更大的技能评价压力,影响了临床医师执业准入的质量,为国际医学人才流动带来不便。停考政策启发我们充分认识临床技能评价的重要意义,不断完善医师资格考试实践技能考试的设计和实施;在考试组织实施中重视效度证据的整合,重视平衡考试社会效益的最大化和考试成本的可承受性;有效发挥执照考试的评价反馈作用,与医学院校协同提升医学生能力水平。
In January 2021, United States Medical Licensing Examination Clinical Skills test was terminated. The test has played a key role in the evaluation of physician' competence, and has been a model for medical examinations since its launch. Although difficulty caused by COVID-19 outbreak is the leading cause, the test has been fighting its way in terms of test cost, content validity, and effective feedback. Test termination policy will transfer burden of competence evaluation to medical schools and thus deeply affect medical education, will reduce the quality of licensure exam and licensed physicians, and will bring inconvenience to international medical personnel flow. The policy inspires us to fully understand the importance of clinical skill assessment and to improve competency evaluation in licensure exams, to pay more attention to social consequences of the test and to attach importance to the integration of validity evidence in the organization and implementation of examinations, to effectively play the role of examination feedback and cooperate with medical schools to enhance the ability of medical graduates.
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