目的 以考生实测数据验证乡村全科执业助理医师资格考试医学综合笔试考试设计的认知能力模型,为提高考试质量提出建议。方法 采用验证性因素分析方法,对不同学科的认知过程潜在变量设计模型进行检验和校正。结果 将西医理解相关潜在变量调整为应用、将中医应用相关潜在变量调整为理解之后,形成了满意的认知能力模型(拟合度指数均>0.95)。结论 实测数据对认知能力设计模型的支持度较高(>80%),潜在变量高度相关是模型改进的主因,改进的模型兼具科学性和合理性。应当进一步细化认知层次定义,加强试题开发专家培训。

Objective Verification of designed cognitive ability model of medical comprehensive written examination for National Medical Licensing Examination in rural general practitioners by sample data and to provide suggestion on future improvement. Methods Confirmatory factor analysis is applied to test the fitness and to improve the designed cognitive model for various subject contents. Results The designed model is improved by altering western medicine understanding to application and traditional Chinese medicine application to understanding. Fitness indexes are above standard level (>0.95). Conclusions Most part of the designed model is supported by candidate data (>80%). High correlation between latent variables could explain the alternation of the model. The improved model is both scientific and reasonable. Suggestions are provided to better define the cognitive levels and to enhance SME training.