目的 评价客观结构化临床考试在江苏省内科住院医师规范化培训(以下简称规培)结业考核中的有效性和可靠性,为进一步制定规范化、科学化的考试方案提供参考。方法 本研究采用资料分析方法。2018年9月,选取2013年~2018年江苏省南京鼓楼医院1713名内科住院医师的规培结业考核的客观结构化临床考试成绩为研究对象,分析和评价客观结构化临床考试的合格率、信度、难度和区分度等指标。结果 2013年~2018年,临床技能考核合格率总体上呈上升状态,以2014年为节点,经过大幅上升后趋于稳定,维持在90%左右;考试的平均克朗巴赫系数为0.667,考试的难度系数在0.832~0.892之间,区分度在0.3以上。结论 2013年~2018年江苏省内科住院医师规范化培训的客观结构化临床考试信度较高、难度小、区分水平良好,考试的稳定性和可靠性较好,考试站点和内容的设置上相对合理。要对薄弱项目加强针对性培训,促进考题内容与培训细则紧密结合。

Objective To evaluate the validity and reliability of the Objective structured clinical examination in the final examination of the standardized training of medical residents in Jiangsu Province (referred to as standard training),and to provide reference for further formulation of standardized and scientific examination program.Methods The data analysis method was used.In September 2018,the Objective structured clinical examination scores of 1 713 medical residents in Nanjing Drum Tower Hospital of Jiangsu Province from 2013 to 2018 were selected as the research objects.The qualification rate,reliability,difficulty and discrimination of Objective structured clinical examination were analyzed and evaluated.Results The passing rate of residency standardized training graduation examination has enhancing persistently.Since 2014,the passing rate is maintained at 90%;The average Cronbach's α coefficient of resident examinations reached 0.667,the difficulty coefficient was between 0.832 and 0.892 and the discrimination was above 0.3.Conclusions From 2013 to 2018,Objective structured clinical examination in residency standardized training graduation examination in Jiangsu Provincehas high reliability,low difficulty and appropriate discrimination,and relatively reasonable in the examination site and content.It is necessary to strengthen targeted training for cites with low score and to promote the close integration of test content and training rules.