A Preliminary Study On The Empirical Validity Of Physician Qualification Examination

IntroductionAs a medical access examination,Clinical Physical Qualification Examination is a comprehensive evaluation for practicing doctors practical thought process and the ability to work.Examination must have high reliability and validity in order to accurately reflect the research object to be measured by the knowledge and skills.At the same time of observing the validity of the exam,we should not only focus the reliability of the score,but also consider the performance of the objects in the test and in other situations such as the performance in daily work.The most important factor to the clinical physical qualification examination is that how to determine the empirical validity of the criterion.It is important to determine the empirical validity of the criterion.Examination of the performance from the standard high and low degree may be related with another relevant test scores.The study may also be a performance from practice.Physicians compared by the qualifying examination with a similar test time,content and structure,could be analyzed as a total with two degrees.We could choose some doctors to take part in the study of the qualifying examination at a comparatively short time and other doctors take part in the qualifying examination of the theory and practice similar examinations.If the consistency of the two higher tests scores,it could be proved to get both the high validity.In contrast,the consistency of the two lower test scores can not determine the effect of the subjects as the ideal test.The reliability and validity needs further study. Qualifying examination is the evaluation for physicians,the selection and appointment is important examination practitioner,the examination results should be a good prediction study from the performance in practice.The same study the performance and physicians should also be the qualifying examination score line,such only with ideal test validity. To observe the objects,we will collect the performance in daily work or just let the physician take part in the qualifying examination as doctors.About their work in the medical evaluation of the performance,the evaluation will include treatment of patients, disease-chi records,the use of self-evaluation,the patient evaluation,peer evaluation and higher-level physicians and other team members or organizations such as the evaluation of methods for the collection of such information.Study the performance of work in these out of professional knowledge and skills is qualifying examination by a doctor to assess,therefore,is to examine the validity of doctors qualifying examination of the objective,the real criterion.Empirical validity of the study is to determine the criterion,compared with the examination results,analysis of the validity of physician examination;it is also known as criterion-related validity(Criterion-related Validity). To establish a standardized test,empirical validity is an important means to tests.In countries abroad,the research of the empirical validity has been carried out in medical examination on.In domestic aspects of the medical examination research carried out focused on the classification of the examination,test preparation and analysis,test management,test item bank construction and evaluation of data analysis, formed a complete theoretical system,and promote the improvement of the quality of medical examinations.However,the medical examination is not as much as empirical studies,only some of the existing schools to predict the test study,the conclusions reached by the main service in teaching,there is less literature reports,there is no systematic collection of data collation in the relevant empirical research.Qualifying examination for doctors of the empirical studies has not yet been carried out from the point of view or practice and evaluation.From the empirical perspective of the study physician qualification examination,the establishment of empirical validity study to improve methods and theory is necessary.In this study,the perspective from an objective evaluation of the practice of doctors qualifying examination results reflects the extent of the real situation.Through the collection and analysis of empirical data to study the actual performance of the other(work or other examinations) for physician evaluation criterion validity of the qualifying examination,the qualifying examination is carried out in order to promote the improvement of doctors and improve.Subjects and Methods 60 residents graduated at 2007 from China Medical University are used as the research subjects,including 22 residents from the First Affiliated Hospital,31 from Affiliated Shengjing Hospital and 7 from the Forth Affiliated Hospital,of which 29 are male and 31 are female.The test has been taken during September 23,2008 to September 26,2008.The test consists of OSCE and Theory Examination.All statistics and psychometrics analysis,including difficulty,differentiation,reliability,validity and reliability,were done with SPSS 12.0.Results1,The basic situation of the annual assessmentTheory test part of the annual assessment reliability was 0.803 in order to study the theory comprehensive exam graduation examination results as a criterion,the validity was 0.495.The theory test is divided into the average 31.3,standard deviation of 3.215.Results and comparison between men and women were no significant differences;between the various hospitals has also been no significant difference.Part of the annual assessment skills test average 30.5,standard deviation of 3.215. After statistical analysis,found that case-mix reliability is between 0.483 to 0.843.The average degree of difficulty is 0.57.To distinguish between an average of 0.45,to illustrate the distinction between the majority of cases a better degree.2,Clinician's empirical validity of the qualifying examination of the analysisClinicians qualifying examination and annual examination of a total score of the theory,basic knowledge of some of the achievements,expertise and public knowledge of some part of the results are relevant.Cognitive point of view the classification of the results showed that the classification of the three cognitive levels,clinicians qualifying examination and annual examination were significantly related.Skills assessment and annual examinations of the relevant part has a significant statistical significance.From a theoretical examination and graduation examinations,OSCE examinations are relevant.Stepwise regression analysis showed that the annual assessment of basic knowledge and expertise in some part of the qualifying examination for clinicians influenced.Score the performance of day-to-day relevance of the measurement analysis showed that clinical results of the qualifying examination and study the performance of daily work was no significant correlation.Clinicians could not confirm the qualifying examination of research subjects in their daily work to reflect the performance of. Discussion1,The assessment of annual exam of the reliability,the difficulty and the discrimination(1) the annual assessment of reliabilityAnnual assessment of the reliability of better reliability coefficient was 0.803 can think better reliability.A lot of study after the test reflected in the annual examination of the questions with a certain degree of difficulty,the response can be seen from the test results,with an average of only 61.86 achievements,the passing rate of only 67%. This is the same group for the study of clinical physician qualifying examination pass rate is 95%there are some differences.That is difficult to test the impact of the test reliability.(2) SP test the difficulty and discrimination casesAnnual examination of the standardized patient examinations in the average degree of difficulty is 0.57;from the criterion-test a total of seven cases to distinguish between the five coefficients above 0.30 can be considered good quality of the cases.2,The empirical analysis of the clinicians qualifying examination validity(1) Qualifying Examination clinicians validity of the surfaceValidity refers to the surface from the appearance of the examination will be able to understand what is to be measured.In view of the recognized candidates on the examination and acceptance of,and a positive attitude to participate in the qualifying examination clinicians can be considered the validity of the examination of the surface better(2) Clinical examination content validityClinical examination and assessment of candidates eligible for the more comprehensive scope of clinical competence,and basic clinical training to represent the specific target,can serve as a clinical assessment of the capacity of the individual part of the standard results.Due to the current estimate of content validity there is no appropriate method of calculation,so to judge by experts to speculate that the statutory test of content validity.(3) Empirical validity of the clinicians qualifying examinationThe results of the analysis also showed that clinicians qualifying examination and annual examination of the vast majority of questions from the theory and cognitive assessment are graded significant correlation in both,at the same time the skills assessment is also significantly correlated.Aspects of the public examination of the content because of the need to cover more topics at the same time less objective factors such as the impact,relevance is not very high.Assessment of predictive validity to the study of the graduation examination of predictive validity as a criterion,the analysis of the relevance of the two examinations was significantly more clinicians to prove the validity of the qualifying examination and a good reliability.At the same time in order to study the performance of day-to-day score for the criterion measures,clinicians can not prove that the qualifying examination and study of day-to-day performance.(4) Clinicians empirical aspects of the qualifying examination of the issues to be resolvedClinical study results with their physicians the qualifying examination of the relevance of day-to-day performance was not significant,also,to a certain extent that clinicians focus on the qualifying examination for the candidates based on clinical and professional knowledge of the extent of the test,and the lack of medical professional values,attitudes,behavior and ethics,community health and health systems, communication skills,critical thinking and research in areas such as the test.Conclusion1,The annual assessment of evaluation results is reliable and effective.2,China Medical University's residents annual session to the clinical physician and the relevance is a good qualifying examination.3,The comprehensive study of the graduation examination results with the clinicians of the relevance of the qualifying examination better.4,The study of day-to-day performance evaluation of physicians and clinical relevance of the qualifying examination of no statistical significance,subject to further study.5,The qualifying examination clinicians construct validity require further study.