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标题：Visions and reality: the idea of competence-oriented assessment for German medical students is not yet realised in licensing examinations
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作者：Markus Huber-Lang ; Annette Palmer ; Claudia Grab 等
期刊名称：GMS Zeitschrift für Medizinische Ausbildung
印刷版ISSN：1860-3572
出版年度：2017
卷号：34
页码：1-20
DOI：10.3205/zma001102
出版社：German Medical Science
摘要：Objective: Competence orientation, often based on the CanMEDS model, has become an important goal for modern curricula in medical education. The National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM) has been adopted in Germany. However, it is currently unknown whether the vision of competence orientation has also reached the licensing examination procedures. Methods: Therefore, a prospective, descriptive, single-centre, exemplary study design was applied to evaluate 4051 questions/tasks (from 28 examiners at 7 two-day licensing oral-practical exams) for undergraduate medical students at the University of Ulm. The oral and practical questions/tasks as well as the real bedside assessment were assigned to specific competence roles (NKLM section I), categories (NKLM section II) and taxonomy levels of learning domains. Results: Numerous questions/tasks were set per candidate (day 1/2: 70±24/86±19 questions) in the licensing oral-practical exam. Competence roles beyond the “medical expert” were scarcely considered. Furthermore, practical and communication skills at the bedside were hardly addressed (less than 3/15 min). Strikingly, there was a significant predominance of questions with a low-level taxonomy. Conclusions: The data indicate a misalignment of competence-oriented frameworks and the “real world” licensing practical-oral medical exam, which needs improvement in both evaluation and education processes.
关键词：medical competence; high; stakes exam; alignment; roles; NKLM