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題名:歷屆臺灣國家醫師執照考試之分析
書刊名:醫學教育
作者:黃天祥高美英林明燦王維典曾國藩黃秀芬符文美 引用關係郭鐘金楊培銘 引用關係王錦堂 引用關係蔡瑞章蔡文友李秉穎謝博生 引用關係
作者(外文):Huang, Tien-shangKao, Meei-yingLin, Ming-tsanWang, Wei-deanTseng, Guo-fangHuang, Shiu-fengFu, Wen-meiKuo, Chung-chinYang, Pei-mingWang, Jin-townTsai, Jui-changTsai, Wen-yuLee, Pin-ingHsieh, Bor-shen
出版日期:1999
卷期:3:1
頁次:頁40-52
主題關鍵詞:國家醫師執照考試基礎臨床整合臨床病例Medical licensee examinationBasic and clinical science integrationCase study
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
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  • 共同引用共同引用:10
  • 點閱點閱:4
     醫師檢覆考試之目的在於衡鑑醫學生是否已具備行醫必備之學識與技能,以發給醫師執照。臺灣實施此制度已三十多年,自民國八十三年實施二階段考試,但未有系統分析之研究報告,近年來批評之聲時有所聞,且醫學教育改革舉世靡然,此時是對此考試加以分析研究以針砭弊病,提供改進方案之適當時機。由基礎學科及臨床學科就不同領域邀請二至三位教師,就民國八十三年至八十七年共十次的醫師檢覆考試內容如題目的類型、題目的特性、臨床和基礎之相關度、試題難易度加以分析,另對臨床醫學題目予以歸類,探討其領域分佈,是否屬於十大死因之疾病和疾病之常見的程度。結果發現基礎與臨床相關性太低,題目多屬記憶性,缺乏思考性,因此題目深入度不夠,偏重細節,困難題目比例偏低,甚至有些題目和實際生活或臨床疾病脫節。其次領域分布不均,每次考試差異極大。缺乏臨床實例試題難以測試應試者收集資料、分析結果、判讀影像、檢驗結果,推理產生假說及解決問題能力。又因本土資料常不見於教科書內,本土重要疾病比例偏低等缺失。為改進上列缺失,建立國家醫師執照考試的出題基準應為急務,多以臨床病例或基礎臨床整合題目測試應試者運用知識和解決問題的能力。
     The purpose of the medical licensee examination (MLE) is to determine whether a medical graduate possesses the knowledge and ability to practice medicine. The MLE has been administered to all medical graduates inTaiwan for more than thirty years and a two-step examination has been adopted since 1994. In spite of variouscriticisms of the examination process, content and format there are still no published studies of the MLF in Taiwan. The recent advocation of medical education reform highlights the need for timely analysis of the MLE in order to make sound recommendations to improve it. Two or three teachers from each of the various fields of basic and clinical science were invited to participate in this study. The characteristics of MLE examination questions of the period from 1994 to 1998 were analyzed and the degree of correlation between basic and clinical science, degree of difficulty, distribution of topics in various clinical fields, frequency of clinical problems, and the relation of questions to the ten most common causes of death in Taiwan were studied. The result show that there were several shortcomings in the MLIE questions. First, the integration of basic and clinical science on the tests was poor. Second, most of the questions emphasized knowledge recall rather than thinking processes, and as a consequence the questions were superficial and fragmented. Third, many of the questions were not of sufficient difficulty or were irrelevant to clinical practice. Fourth, the variation of distribution of questions among clinical fields was significant in these years. Fifth, there was a lack of case study questions to test ability in data gathering, analysis of laboratory test results, image analysis, hypothesis formation and solving clinical problems. Furthermore, locally important medical issues only occupied a small percentage of the MLE. In order to amend these deficiencies in the MLIE, if will be necessary to redesign thee test with an emphasis on the integration of clinical and basic science and to include case study questions to test the abilities of medical school graduates to apply their knowledge in the solution of clinical problems.
期刊論文
1.楊明仁、蔡瑞熊(19970600)。從社會與教育制度看臺灣醫師人才的培養。醫學教育,1(2),21-28。new window  延伸查詢new window
2.Carroll, R. G.(1993)。Evaluation of vignette-type examination items for testing medical physiology。American Physiological Society,264,S11-S15。  new window
3.Swanson, D. B.、Case, S. M.、Waechfer, D.(1993)。A preliminary study of the validity of pass/fail standards for USMLE steps 1 and 2。Acad Med,68,S19-S21。  new window
4.Swanson, D. B.、Ripkey, D. R.、Case, S. M.(1996)。Relationship between achievement in basic science coursework and performance on 1994USMLE Step 1 test administrations。Acad Med,71,S28-S30。  new window
5.Case, S. M.、Ripkey, D. R.、Swanson, D. B.(1996)。The Relationship between clinical science performance in 20 medical schools and performance on Steps 2 of the USMLE licensing examination。Acad Med,71,S31-S33。  new window
6.Brailovsky, C. A.、Grand'Maison, P.、Lescop, J.(1995)。Residency directors' predictions of candidates' performances on a licensing examination。Acad Med,70,410-414。  new window
7.Case, S. M.、Becker, D. F.、Swanson, D. B.(1993)。Performances of men and women on NBME Part I and Part II: The more things to change。Acad Med,68,S25-S27。  new window
8.Weinberg, E.、Rooney, J. F.(1973)。The academic performance of women students in medical school。J Med Educ,48,240-247。  new window
9.Case, S. M.、Swanson, D. B.、Ripkey, D. R.(1996)。Performance of the class of 1994 in the New Era of USMLE。Acad Med,71,S91-S93。  new window
10.Ripkey, D. R.、Case, S. M.(1996)。Examinees' perceptions of factors influencing their performance on USMLE Step 2。Acad Med,71,S34-S36。  new window
11.Erdmann, J. B.(1993)。Guidance for the use of the USMLE in medical education settings。Acad Med,68,732-733。  new window
圖書
1.謝博生(1997)。醫學教育--理念與實務。台北市:金名圖書有限公司。  延伸查詢new window
2.考試院(1996)。考銓報告書。台北:考試院。  延伸查詢new window
 
 
 
 
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