网络化考试在临床医学专业实习出科考核中的应用与研究

目的 评估某高校临床医学专业网络化出科考试题库的整体质量。方法 依托某校题库与网络考试系统为技术支持，组建网络化出科考试题库，于2017 年5 月6 日～ 6 月24 日期间组织2 432 人次参加测试，采用单因素方差分析（ANOVA）方法，以信度（R）、难度（P）、区分度（D）为指标来进行评价。结果 除内分泌科、 肾内科和骨科外，其他14 个科室的试题题库均较为稳定（P-value<0.05）；除神经外科第4 次考试的试题难度D 为0.85 和骨科第2 次考试信度R 为0.56 外，其他科室试题的难度、信度和区分度均在参考值范围内（分别为0.51-0.84，0.62-1，0.13-1）。结论 该高校的网络化试题题库中各科室试题信度较高，难度适中，能较好的将学生的知识掌握程度区分开来，可向其他医科院校推广使用。

Application and research of computer-based examination in the Department Examination of Clinical Medicine Practice

Objective To evaluate the overall quality of the computer-based test question bank for clinical medicine in a college. Methods Based on a school item bank and computer-based examination system as technical support, a computerbased test question bank was set up. From May 6 to June 24, 2017, 2432 people participated in the test, and one-way analysis of variance (ANOVA) was used. The reliability (R), difficulty (P), and degree of differentiation (D) were used as indicators for evaluation. Results Except for endocrinology, nephrology and orthopedics, the test question bank of the other 14 departments were all stable (P-value ＜ 0.05); except for the fourth exam of neurosurgery, the difficulty D was 0.85 and the second examination of orthopedics has a reliability R of 0.56, the difficulty, reliability, and differentiation of the questions in other departments are within the reference range (0.51-0.84, 0.62-1, 0.13-1). Conclusion The reliability of the examination questions in each department of the university’s computer-based test questions database is relatively high, and the difficulty is moderate. It can better separate students’knowledge mastery and can be used to promote other medical schools.