국가면허시험, 유럽면허시험, 또는 아무것도 안 하기? (Med Teach, 2009)

국가면허시험, 유럽면허시험, 또는 아무것도 안 하기? (Med Teach, 2009)

National, European licensing examinations or none at all?

C. P. M. VAN DER VLEUTEN

Maastricht University, The Netherlands

고등교육 일반과 의학교육에서 유럽의 통합은 특이하다. 볼로냐 선언 이후 대부분의 유럽 국가들은 two-cycle 훈련 프로그램을 도입하였고, 의과대학에도 이러한 것이 도입되었다. European legislature에서 전문직의 자유로운 mobility가 있다. 유럽 전역에 걸친 교육 이니셔티브의 퀄리티를 관리하기 위하여 고등교육을 accredit하려는 움직임이 있다. 

The unification of Europe in higher education in general and in medical education in particular is progressing. Since the Bologna declaration most of the European countries are in the process of introducing a two-cycle training programme in higher education that also affects medical training programmes (Patricio et al. 2008). Within the European legislature there is free mobility of professionals across the borders of Europe. To control for quality of education initiatives are taken across Europe to accredit higher education programmes (Dittrich et al. 2004) including medical training programmes (van Zanten et al. 2008).

근대 유럽의 일부분은 노동력의 mobility와 그 경향을 함께 한다. 그렇다면 질문은 "이 모든 것에서 환자의 목소리는 어디로 갔는가? 환자의 권리는 이 유동성에 대해서 어떻게 지켜지고 있는가?"이다. 유럽 의과대학들은 서로 다른 퀄리티의 졸업생을 양성하고 있다. 만약 전 유럽적 관점에서 보면 어떠한가? Athens 의과대학 졸업생은 Tampere의 졸업생과 어떻게 다른가?

Part of modern Europe is also the trend of mobility of the workforce (Jinks et al. 2000). The question is: what is the voice of the patient in all this? How are the rights of the patient protected against this mobility? European country medical schools produce different quality of medical graduates (McManus et al. 2008). What happens if we look at this from a European perspective? How different is a graduate coming froma medical school in Athens as compared to one from Tampere? Or from London compared to Warsaw?

이 문제에 대한 한 가지 접근법은 북미의 면허시험 루트를 따르는 것이다. 그러나 내가 북미로 와서 내 자국에 면허시험이 없다고 말할 때 그들은 날 축하해준다.

One way of dealing with this issue of quality of graduates is to follow the North-American route of licensure examinations. However, when I come to North America and explain that licensing examina- tions do not exist in my country, they sometimes congratulate me.

질문은, 표준화된 시험이 표준화된 (교육) 프로그램을 낳느냐는 것이다. 최근의 평가와 관련된 문헌에서 'testing culture'에서 'assessment culture'로의 이행이라는 패러다임을 주장한 연구자가 있다. 여기서 우리는 assessment of learning을 assessment for learning으로 변화시켜야 한다. 평가의 원동력을 전략적으로 활용하여 평가를 학습 그 자체에 가급적 최대한으로 embed 시켜야 한다. 면허시험은 그 정의상 assessment를 ongoing learning과 구분시킨다.

The question is whether standardized tests lead to standardized programmes. In the recent assessment literature one speaks of a paradigm shift by moving away from the ‘testing culture’ towards an ‘assessment culture’ (Gielen et al. 2003). Here we change from assessment of learning towards assessment for learning. By using the driving effect of assessment strategically it is advocated to embed assessment as much as possible with the learning itself (Wilson & Sloane 2000). Licensure examina- tions by definition separate the assessment from the ongoing learning.

시스템 간 차이가 너무 커서 졸업생간 어떠한 비교도 사실상 불가능하다. 같은 OSCE스테이션에 대해서도 의과대학마다 passing score가 달라서 한 의대에서 합격할 학생이 다른 의대에서는 탈락할 수도 있다.

Finally, this issue of Medical Teacher contains a study by Peter McCrorie and Katherine Boursicot exploring the graduating assessment systems across the UK in terms of content, format, testing time and standard setting procedures(McCrorie & Boursicot 2009). They found wide variation in these systems and conclude that any comparison of graduates is really impossible. Even worse, they cite one of their own studies in which the same procedure used in different medical schools to set passing scores for the same OSCE stations resulted in such widely differing passing scores that students who would have passed in one medical school would have failed in another (Boursicot et al. 2006). They therefore conclude it is time to reassure the public by introducingnational qualifying examinations. 

Archer J. 2009. European licensing examinations – The only way forward. Med Teach 31:215–216.

McManus IC, Elder AT, De Champlain A, Dacre JE, Mollon J, Chis L. 2008. Graduates of different UK medical schools show substantial differences in performance on MRCP(UK) Part 1, Part 2 and PACES examinations. BMC Med 6:5.

McCrorie P, Boursicot K. 2009. Variations in Medica School Graduating Examination in the United Kingdom: Are clinical competence standards comparable? Med Teach 31:223–229.

Melnick D. 2009. Licensing examinations in North America: Is external audit valuable? Med Teach 31:212–214.

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Med Teach. 2009 Mar;31(3):189-91.

National, European licensing examinations or none at all?

van der Vleuten CP1.

Author information

• 1Maastricht University, The Netherlands.

PMID:

 

19811114

[PubMed - indexed for MEDLINE]