Obesity Coverage on Medical Licensing Examinations in the United States. What Is Being Tested?
Obesity Coverage on Medical Licensing Examinations in the United States. What Is Being Tested?
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DOI：
10.1080/10401334.2016.1250641
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发表时间：
2017-01-01
影响因子：
2.5
通讯作者：
Aronne, Louis J.
中科院分区：
文献类型：
--
作者：
Kushner, Robert F.;Butsch, W. Scott;Aronne, Louis J.
现象。作为影响成人和儿童的最常见慢性疾病之一，肥胖是国内和全球非传染性疾病的主要原因。肥胖会对每个器官系统产生不利影响，因此美国医学执照考试 (USMLE) 必须充分评估学生对肥胖管理的科学和实践的了解。本研究的目的是评估三项 USMLE Step 考试中肥胖相关项目的覆盖范围和分布。方法。包含肥胖相关关键词的检查项目由国家体检委员会 (NBME) 工作人员确定。由 6 名内容专家组成的小组评估了所有项目，并使用美国肥胖医学委员会 (ABOM) 测试大纲标准将肥胖相关项目编码为 4 个域和 107 个子域。发现。 NBME 确定了 802 个包含肥胖相关关键词的多项选择题，其中 289 个（36%）被确定为与肥胖相关，并被编码到适当的域和子域中。在各个领域中，诊断和评估领域包含所有 3 步骤检查的大部分项目 (174)。 58% 的项目由 17 个器官系统中的 4 个代表，80% 的编码项目由 6 个 ABOM 子域代表。大多数肥胖编码项目涉及肥胖相关合并症的诊断和管理，而不是解决肥胖本身的预防、诊断或管理。见解。 Step 考试中没有体现肥胖预防和治疗的最重要概念。考试项目主要涉及肥胖相关合并症的诊断和治疗，而不是肥胖本身。专家评审小组发现了许多与肥胖相关的重要主题，这些主题在检查中没有得到充分解决或完全缺失。评审人员建议，确定的改进领域可能会促进对肥胖知识进行更平衡的测试。
Phenomenon. As one of the most common chronic disease affecting adults and children, obesity is a major contributor to noncommunicable diseases, both nationally and globally. Obesity adversely affects every organ system, and as such it is imperative that the United States Medical Licensing Examination (USMLE) adequately assesses students' knowledge about the science and practice of obesity management. The purpose of this study was to evaluate the coverage and distribution of obesity-related items on the three USMLE Step examinations. Approach. Examination items that included obesity-related keywords were identified by National Board of Medical Examiners (NBME) staff. A panel of 6 content experts evaluated all items and coded obesity-relevant items using the American Board of Obesity Medicine (ABOM) test outline rubric into 4 domains and 107 subdomains. Findings. There were 802 multiple-choice items containing obesity-related keywords identified by NBME, of which 289 (36%) were identified as being relevant to obesity and were coded into appropriate domains and subdomains. Among the individual domains, the Diagnosis & Evaluation domain comprised most of the items (174) for all 3 Step examinations. Fifty-eight percent of items were represented by 4 of 17 organ systems, and 80% of coded items were represented by 6 ABOM subdomains. The majority of obesity-coded items pertained to the diagnosis and management of obesity-related comorbid conditions rather than addressing the prevention, diagnosis, or management of obesity itself. Insights. The most important concepts of obesity prevention and treatment were not represented on the Step exams. Exam items primarily addressed the diagnosis and treatment of obesity-related comorbid conditions instead of obesity itself. The expert review panel identified numerous important obesity-related topics that were insufficiently addressed or entirely absent from the examinations. The reviewers recommend that the areas identified for improvement may promote a more balanced testing of knowledge in obesity.