A Preliminary Study On Assessment Index System Of Comprehensive Quality Of Clinical Medical Undergraduates

BackgroundStudents’assessment is based on specific objectives and criterion on education and is practiced through systemic collection and utilizing correlative information, judging the condition of student’s comprehensive qualities as well as the objective effects of education from quality aspect, which helps to give feedbacks、diagnose、 guide、and encourage students. Assessment is a quality assured tool which helps to stir potentials and to advance development. The education on clinical medical undergraduates is the basis and fundament of the overall tertiary education of medicine. Therefore, the assessment of comprehensive qualities of clinical medical bachelors guarantees the students’ training quality in universities. The most important premise of implementing assessments is to establish a scientific criteria system, which including the criteria contents and how every single weight of each criteria distributes. As we have deeper understanding into the intension of human qualities, the development of our society、tertiary education and medical industry bring new requirements and challenges to the education objective and assessment criteria for clinical medical undergraduates. Currently, however, those assessments for medical students are not updated to satisfy the new requirement. It is a normal problem that tutors pay more attention to credits of each course not to students’ skills and examinations focus on assessing students’memory of books but ignoring their creation、medical ethics and communication skill, which is a not comprehensive assessment. In terms of assessment criteria, currently there have many researches have been done regarding the assessment of external features such as medical theory、clinical skills and communication skills, but few researchers focus on the internal features. Quality is decomposed and not systemic, and its definition is overlapped and unclear, which enable the assessment criterion, lacking quantitative studies, to have more weights. Overall, there is no a comprehensive and systemic assessment criterion existing for the clinical medical undergraduates. Thus, without doubt, It is significant and essential to establish such a system mentioned above.ObjectiveThis research aims to establish an assessment criteria system which is scientific、 enabling quantization to compare、suitable to the medical development、satisfying the objectives of education as well as to provide good examples to medical universities, which could be adopted into the assessment for clinical medical students.Methods1、Studying references:this is a method helping to understand the truth of science, which is implemented by collecting、reading、analyzing references. This research mainly relies on collecting data from the following four aspects: firstly, the quality structure and intension of human beings; Secondly, the development of medical industry; Thirdly, the objectives of medical education; Fourthly, the comprehensive quality of medical students. Through studying references, we can decide the specific items of preliminary assessment criteria.2、Systemic analyzing:this method is to consider the studying items as a connective system as well as to study the connections and functions of its internal factors and how those functions affect all around. The assessment criteria of clinical medical undergraduates can be classified two first class indexes (The credit index and the non-credit index). The credit index is categorized into second class index such as medical knowledge、humanistic knowledge and techniques; The non-credit index includes interpersonal skills、 physical&mental quality、idealðics, etc. Each single second class index contains its many items. From the respect of systemic analyzing, we are ought to make every class index decomposed specifically、not overlapped and in detail.3、Brainstorm:Brain storming is also called intellectual stimulating. This method is open discussed among relevant tutors form Southern Medical University and Southern Hospital. The purpose is, in terms of contents of items of preliminary assessment criteria, to adjust contents step by step and to establish a relatively comprehensive criteria system which is classified specifically and structured clearly.4、Interviewing experts:in terms of a relatively comprehensive criteria system, it is designed to invite clinical doctors、tutors and experts, working in school、 hospital、clinical management of medical students from Southern Medical University、Southern Hospital and Military police Guangdong hospital, to adjust、revise and improve our research to ensure the pre-questionnaires.5、Delphi Method:this research is to adopt Delphi Method, which makes the selected indexes well framed. Then, these selected indexes would be sent to22experts for assessment, testing the reasonability、importance、feasibility and weighted value of every class indexes.This study involves preliminary study and two formal Delphi studies. To make this criteria system scientific and reliable, expert positive coefficient、expert authority coefficient、degree of opinion centralization and degree of opinion coordinating are all utilized to decide the reliable degree of consulting experts.6、Statistics:(1) Descriptive statistics:It describes the age and knowledge structure of experts, and then counting the expert positive coefficient (retrieved rate of questionnaires)、effective rate of questionnaires.(2) The Coefficient of variation:The coefficient of variation is defined as the ratio of the standard deviation to the mean. Our study is ought to be based on reality, when selecting the indexes, the importance and feasibility are designed to be standard when less than25%and to be eliminated when more than25%. Furthermore, as the basic sore of weighted index planned as100, and the value spanned significantly. Thus, the coefficient of variation of weight ought to be standard with less than40%, and the coefficient should be deleted with over40%.(3) The Expert authority coefficient:the expert authority degree is decided by two elements:one is how experts decide on these indexes (Ci); the other is how experts are familiar with the questions (Cs). The formula of experts authority degree is defined as:Ca=(Ci+Cs)/2.(4) Kendall’s W coefficient. Kendall’s W is a very important index, which helps to figure out experts’ coordinating degree on one or whole indexes via calculating. It is normally described as W (ranges:0-1). The bigger the W, the better the coordinating degree is. In contrast, the small numbers reflect the degree of experts’ opinions coordinating is relatively low. This study is about to set the Kendall’s W as0.7.7、Analytic hierarchy process:The analytic hierarchy process is utilized to decide the weight of second class index during the second round of consultation. The questionnaire involves graphs whose contents are specific and clear. Experts need to respectively give scales (ranges:1-9) to the importance degree of two groups of second class index (4indexes/each),and then to build matrices of pairwise comparison to calculate the relative weighted valve of the index compared. Since some experts possibly make decisions against common sense during the consultation, in another word, the decisions are not consistent, thus, the consistency check is required when studying matrices.Results1、The first round results of expert consultation(1) The expert positive coefficient is95.45%, and the effective rate of questionnaire is95.24%.(2) The authority coefficients among20experts are all between0.78-0.95, which averaged at0.87.(3) The weighted value of the credit index and non-credit index are63.5%and36.5%respectively, and Coefficients of variation of both are less than25%.(4) The overall coefficient experts advised on each weighted value of index is less than0.7(result is0.697), and through chi-square test, P<0.01.(5) The mean value of importance ranges from3.90to4.85with all the coefficients of variation are less than25%; The mean value of feasibility ranges from3.15to4.50with all the coefficients of variation are less than25%; The weighted coefficients of variation, except for the coefficient of variation in Respect is over40%(result is61.1%), are all less than40%.2、The second round results of expert consultation(1) The expert positive coefficient is90.91%, and the effective rate of questionnaire is100.00%.(2) The mean value of the expert authority coefficient ranges from0.75to0.97, and the mean value is0.88.(3) The weight values of the credit index and not-credit index are63%and37%respectively, and coefficients of variation of both are all less than25%.(4) The results of Analytic hierarchy process:normalized process and consistency check have been utilized upon20experts’decisions on matrices, and all experts’ CRs are less than0.1. Based on experts’ advice, The weights of medical knowledge、humanistic knowledge、other fundamental knowledge and skills distribute as0.5078、0.1310、0.0793and0.2819respectively; and the weights of interpersonal skills、physical&mental quality、idealðics and others (creation、forte&hobbies and comprehensive humanistic knowledge) distribute as0.2561、0.2570、0.2829and0.2040respectively.(5) The overall coefficient of coordinating experts advised on each weight of index is0.828; through the chi-square test, P<0.01.(6) The mean value of feasibility ranges from3.85to4.45,and all coefficients of variation are less than25%; The mean value of assessment on importance ranges from4.00to4.95, and all coefficients of variation are less than25%; The weighted coefficients of variation on each index are all less than40%, The biggest coefficients among all indexes is the Prospect of History and Politics, which is25.8%.ConclusionThrough working on analyzing the features of objectives on education as well as consulting with experts, this study has drafted a frame which explains the contents of assessment criteria on comprehensive qualities of clinical medical undergraduates. Based on this, the weights of each class index are ensured via taking advantages of Delphi and statistics methods. Under tests, the expert positive coefficient、expert authority coefficient、degree of opinion centralization and degree of opinion coordinating all satisfy the requirements.Finally, a comprehensive criteria system is established:the credit index is63.00,including medical knowledge (30.24)、humanistic knowledge (10.08)、other fundamental knowledge (5.98)、and skills(16.70) with4second class indexes and11third class indexes; The not-credit index is37.00, involving interpersonal skills (9.25)、physical&mental quality (9.53)、idealðics(11.19) and other skills (7.03) with4second class indexes and12third class indexes.