Abstract: 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.

Key words: Medical licensing examination, Integrated items, Difficulty, Discrimination