医学教育程序性评价的国际多案例比较研究

王文涛; 鲁子越; 潘俊颐; 沈健; 李响

doi:10.3760/cma.j.cn116021-20260210-02317

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医学教育程序性评价的国际多案例比较研究

胜任力评价专题 | 更新时间：2026-10-26

- 医学教育程序性评价的国际多案例比较研究
- An international multi-case comparative study of programmatic assessment in medical education
- 中华医学教育探索杂志 2026年25卷第10期页码：1180-1190
- 作者机构：
  
  1.重庆医科大学莱斯特大学联合学院，重庆 400016
  2.重庆医科大学附属第一医院心血管内科，重庆 400016
  3.重庆医科大学教务处，重庆 400016
- 作者简介：
  
  李响，Email： lzd9288@163.com
- 基金信息：
  
  重庆市高等教育教学改革研究重点项目(232047);重庆市高等教育学会高等教育科学研究课题(cqgj25zx10C);重庆医科大学校级教育教学改革研究项目重大项目(JY20250202);重庆医科大学附属第一医院研究生教育教学改革项目(CYYY-YJSGXM-202309)
- DOI：10.3760/cma.j.cn116021-20260210-02317
  中图分类号： R-0;R-4
- 收稿：2026-02-10，
  
  纸质出版：2026-10-20
- 稿件说明：
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王文涛, 鲁子越, 潘俊颐, 等. 医学教育程序性评价的国际多案例比较研究[J]. 中华医学教育探索杂志, 2026, 25(10): 1180-1190.

Wang Wentao, Lu Ziyue, Pan Junyi, et al. An international multi-case comparative study of programmatic assessment in medical education[J]. Chinese Journal of Medical Education Research, 2026, 25(10): 1180-1190.
王文涛, 鲁子越, 潘俊颐, 等. 医学教育程序性评价的国际多案例比较研究[J]. 中华医学教育探索杂志, 2026, 25(10): 1180-1190. DOI： 10.3760/cma.j.cn116021-20260210-02317.

Wang Wentao, Lu Ziyue, Pan Junyi, et al. An international multi-case comparative study of programmatic assessment in medical education[J]. Chinese Journal of Medical Education Research, 2026, 25(10): 1180-1190. DOI： 10.3760/cma.j.cn116021-20260210-02317.

摘要

目的

通过跨国多案例比较，分析医学教育程序性评价的实施取向、评估工具、反馈支持、进展评议和信息系统支撑，为我国医学教育评价改革提供参考。

方法

检索PubMed，并结合Web of Science和Scopus补充核查，检索截至2025年11月10日的相关文献。纳入明确报告实施程序性评价或具备其核心特征的医学教育实证研究，经项目归并后，依据项目成熟度、文献支撑度、代表性、情境差异和资料完整性遴选典型案例，并围绕实施取向、证据来源、反馈支持、进展评议和信息系统进行比较。

结果

共检索文献3 863篇，最终纳入55篇实证研究，识别23个医学教育项目，遴选8个典型案例，涉及6个国家。其中本科医学教育项目4个、研究生医学教育项目2个、住院医师规范化培训项目2个。持续反馈或导师反馈覆盖8个案例，覆盖率为100.00%；信息系统或学习档案系统覆盖7个案例，覆盖率为87.50%；临床表现评估、基于工作场所的评估或临床现场观察覆盖6个案例，覆盖率为75.00%；阶段性进展评议或综合审议机制、反思写作或基于学习档案的自我分析均覆盖5个案例，覆盖率均为62.50%。

结论

程序性评价是以持续反馈、纵向证据积累、信息系统支持和关键节点综合判断为核心的系统性评价框架。我国可结合本土资源，从局部试点、最小数据集建设、电子学习档案、导师反馈和阶段性评议机制等方面分阶段推进。

Abstract

Objective

To analyze the implementation orientation

assessment tools

feedback support

progress review

and information system support of programmatic assessment in medical education through a multi-case international comparison

and to provide a reference for medical education assessment reform in China.

Methods

PubMed was searched

with supplementary verification using Web of Science and Scopus

for relevant literature published up to November 10

2025. Empirical studies in medical education reporting programmatic assessment or its core features were included. Studies were merged at the program level

and typical cases were selected according to program maturity

literature support

representativeness

contextual variation

and data completeness. The comparison of these cases focused on implementation orientation

evidence sources

feedback support

progress review

and information systems.

Results

A total of 3 863 records were retrieved. Finally

55 empirical studies were included

23 medical education programs were identified

and eight typical cases from six countries were selected. These included four undergraduate medical education programs

two postgraduate medical education programs

and two standardized residency training programs. Continuous feedback or mentor feedback was reported in eight cases

with a coverage rate of 100.00%; information systems or portfolio systems in seven cases

with a coverage rate of 87.50%; clinical performance assessment

workplace-based assessment

or direct clinical observation in six cases

with a coverage rate of 75.00%; and progress review or comprehensive review mechanisms and reflective writing or portfolio-based self-analysis in five cases each

with a coverage rate of 62.50%.

Conclusions

Programmatic assessment is a systematic assessment framework centered on continuous feedback

longitudinal evidence accumulation

information system support

and comprehensive judgement at key progression points. In China

advancement can be made in stages by drawing on local resources in areas such as local pilots

minimum dataset construction

electronic portfolios

mentor feedback

and progress review mechanisms.

关键词

Keywords

references

van der Vleuten CPM , Schuwirth LWT . Assessing professional competence: from methods to programmes [J ] . Med Educ , 2005 , 39 ( 3 ): 309 - 317 . DOI: 10.1111/j.1365-2929.2005.02094.x http://dx.doi.org/10.1111/j.1365-2929.2005.02094.x .

van der Vleuten CPM , Schuwirth LWT , Driessen EW , et al . A model for programmatic assessment fit for purpose [J ] . Med Teach , 2012 , 34 ( 3 ): 205 - 214 . DOI: 10.3109/0142159X.2012.652239 http://dx.doi.org/10.3109/0142159X.2012.652239 .

齐心 . 医学教育评价的演进及各阶段特征 [J ] . 中华医学教育杂志， 2025 ， 45 （ 5 ）： 332 - 337 . DOI: 10.3760/cma.j.cn115259-20240906-00930 http://dx.doi.org/10.3760/cma.j.cn115259-20240906-00930 .

齐心，闫辉，齐建光，等 . 程序性评价在胜任力导向医学教育中的作用 [J ] . 医学与社会， 2023 ， 36 （ 6 ）： 140 - 144 . DOI: 10.13723/j.yxysh.2023.06.025 http://dx.doi.org/10.13723/j.yxysh.2023.06.025 .

齐心 . 程序性评价的历史演进及其在临床教学实践中的应用 [J ] . 中华医学教育杂志， 2025 ， 45 （ 10 ）： 735 - 739 . DOI: 10.3760/cma.j.cn115259-20250626-00715 http://dx.doi.org/10.3760/cma.j.cn115259-20250626-00715 .

Schut S , Maggio LA , Heeneman S , et al . Where the rubber meets the road: an integrative review of programmatic assessment in health care professions education [J ] . Perspect Med Educ , 2021 , 10 ( 1 ): 6 - 13 . DOI: 10.1007/s40037-020-00625-w http://dx.doi.org/10.1007/s40037-020-00625-w .

Torre D , Schuwirth L , Van der Vleuten C , et al . An international study on the implementation of programmatic assessment: understanding challenges and exploring solutions [J ] . Med Teach , 2022 , 44 ( 8 ): 928 - 937 . DOI: 10.1080/0142159X.2022.2083487 http://dx.doi.org/10.1080/0142159X.2022.2083487 .

王荣，何玉海，史璇，等 . 疫情背景下程序性评价在呼吸科本科生临床教学中的应用 [J ] . 中国高等医学教育， 2025 （ 6 ）： 101- 102， 107 . DOI: 10.3969/j.issn.1002-1701.2025.06.046 http://dx.doi.org/10.3969/j.issn.1002-1701.2025.06.046 .

翟佳燚，陆媛，石建军，等 . 程序性评价在全科临床诊疗思维课程评价中的应用 [J ] . 中国全科医学， 2025 ， 28 （ 4 ）： 420 - 426 . DOI: 10.12114/j.issn.1007-9572.2023.0743 http://dx.doi.org/10.12114/j.issn.1007-9572.2023.0743 .

翟佳燚，陆媛，潘莹，等 . 全科临床诊疗思维课程引进程序性评价课程体验的质性研究：基于建构主义视角 [J ] . 中国全科医学， 2025 ， 28 （ 25 ）： 3193 - 3199 . DOI: 10.12114/j.issn.1007-9572.2023.0933 http://dx.doi.org/10.12114/j.issn.1007-9572.2023.0933 .

Donker EM , van Rosse F , Janssen BJA , et al . The impact of summative, formative or programmatic assessment on the Dutch National Pharmacotherapy assessment: a retrospective multicentre study [J ] . Eur J Pharmacol , 2025 , 989 : 177267 . DOI: 10.1016/j.ejphar.2025.177267 http://dx.doi.org/10.1016/j.ejphar.2025.177267 .

Guth TA , Wolfe RM , Martinez O , et al . Assessment of clinical reasoning in undergraduate medical education: a pragmatic approach to programmatic assessment [J ] . Acad Med , 2024 , 99 ( 8 ): 912 - 921 . DOI: 10.1097/acm.0000000000005665 http://dx.doi.org/10.1097/acm.0000000000005665 .

James M , Baptista AMT , Barnabas D , et al . Collaborative case-based learning with programmatic team-based assessment: a novel methodology for developing advanced skills in early-years medical students [J ] . BMC Med Educ , 2022 , 22 ( 1 ): 81 . DOI: 10.1186/s12909-022-03111-5 http://dx.doi.org/10.1186/s12909-022-03111-5 .

Wilkinson TJ , Tweed MJ , Egan TG , et al . Joining the dots: conditional pass and programmatic assessment enhances recognition of problems with professionalism and factors hampering student progress [J ] . BMC Med Educ , 2011 , 11 ( 1 ): 29 . DOI: 10.1186/1472-6920-11-29 http://dx.doi.org/10.1186/1472-6920-11-29 .

Heeneman S , Schut S , Donkers J , et al . Embedding of the progress test in an assessment program designed according to the principles of programmatic assessment [J ] . Med Teach , 2017 , 39 ( 1 ): 44 - 52 . DOI: 10.1080/0142159X.2016.1230183 http://dx.doi.org/10.1080/0142159X.2016.1230183 .

Tait GR , Kulasegaram KM . Assessment for learning: the university of Toronto temerty faculty of medicine M.D. program experience [J ] . Educ Sci , 2022 , 12 ( 4 ): 249 . DOI: 10.3390/educsci12040249 http://dx.doi.org/10.3390/educsci12040249 .

Ryan A , Judd T . From traditional to programmatic assessment in three (not so) easy steps [J ] . Educ Sci , 2022 , 12 ( 7 ): 487 . DOI: 10.3390/educsci12070487 http://dx.doi.org/10.3390/educsci12070487 .

Bate F , Fyfe S , Griffiths D , et al . A preliminary evaluation of data-informed mentoring at an Australian medical school [J ] . Asia Pac Scholar , 2021 , 6 ( 1 ): 60 - 69 . DOI: 10.29060/TAPS.2021-6-1/OA2239 http://dx.doi.org/10.29060/TAPS.2021-6-1/OA2239 .

Chan T , Sherbino J . The McMaster modular assessment program (McMAP): a theoretically grounded work-based assessment system for an emergency medicine residency program [J ] . Acad Med , 2015 , 90 ( 7 ): 900 - 905 . DOI: 10.1097/ACM.0000000000000707 http://dx.doi.org/10.1097/ACM.0000000000000707 .

Hanley K , McSwiney E , Malley BO , et al . How we built workplace based assessment-for-learning in Irish GP training [J ] . Perspect Med Educ , 2025 , 14 ( 1 ): 411 - 422 . DOI: 10.5334/pme.1428 http://dx.doi.org/10.5334/pme.1428 .

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