目的 分析医师资格考试临床类别医学综合考试中相同知识点非融合型试题与融合型试题的难度与区分度,为医学考试设计提供参考。方法 本研究采用资料分析方法。采用独立样本t检验,比较2014年至2019年医师资格考试临床类别医学综合考试中全部相同知识点非融合型试题与融合型试题难度与区分度的差异。结果 非融合型试题和融合型试题的难度分别为(0.589±0.240)和(0.673±0.204),其差异无统计学意义(P=0.172);非融合型试题和融合型试题的区分度分别为(0.237±0.125)和(0.299±0.092),其差异具有统计学意义(P=0.045)。结论 相同知识点的融合型试题难度与非融合型试题难度无明显差异,融合型试题区分度优于非融合型试题。融合型试题在医师资格考试中的应用能够体现临床医学的实践性特征,彰显了以临床医师胜任力为导向的医学教育理念。   

Objective To provide a new reference for the design of the medical licensing examination and promote the coordinated development of medicine, enducation and examination by analyzing the difficulty and discrimination between the integrated items and non-integrated items for the same knowledge point in clinical medicine comprehensive examination of the medical licensing examination. Methods Data analysis method was adopted in this study. Independent-sample t test was used to detect the diversity of difficulty and discrimination between the integrated items and non-integrated items of the same konwledge point in general knowledge examination of the medical licensing examinations from 2014 to 2019. Results The average difficulty of non-integrated items was (0.589±0.240), and of integrated items was (0.673±0.204), which indicated no significant difference was found (P=0.172). The average discrimination of non-integrated items was (0.237±0.125) and of integrated items was (0.299±0.092), which indicated significant difference(P=0.045). Conclusions Upon the results of examination , there was no significant difference of difficulties between non-integrated and integrated items for the same knowledge point, but the discrimination of the integrated items was obviously better than that of the non-integrated items.The application of integrated items in the medical licensing examination reveals the practical characteristic of clinical medicine, demonstrates the concept of competency-based medical education.