摘要：Background:There has been widespread use of in-training examination for the evaluation of clinical competence of residents. The result of in-training examination seems to be helpful for improving the quality of residency programs using feedback system,further. We evaluated the relationship between residency program and the result of in-training examination. Methods:Reports on the contents of residency program (82 programs) which were submitted in 1999 and in-training examination scores of 516 family medicine residents in 1998 were linked each other through the name of resident. Correlation analysis,t test,ANOVA analysis,and the multiple linear regression analysis were used. Results:Mean score acquired by residents of tertiary hospital residency program (59.4±7.79) was significantly higher than that of secondary hospital (56.4±8.45) among all three residency years. Residents who have seen their own patients in ambulatory care clinic (58.5±8.14) and were given feedback by peer review of teaching faculty (60.2±7.71) acquired significantly better results compared to those who have not (56.1±8.35,57.5±8.27). Residents in programs with moderate ratio of the number of residents to teaching faculty acquired significantly better results compared to those with smaller or larger ratio;the score were 56.2±6.90,59.2±8.64,58.7± 7.90,57.1±8.82 for the ratio of ≤3,4-6,7-9,and 9 <,respectively. Statistically significant but low correlation coefficients (less than 0.25) were observed between in-training examination score and the period of rotation to learn family medicine,general medicine,dermatology,musculoskeletal problem,and the neuro-sensory problem. After controlling probable confounders,third year of residency,residency program in tertiary hospital,and the moderate ratio of residents to teaching faculty were significantly associated with the better result of in-training examination. Conclusion:For improving clinical competence of residents in family practice,limiting the ratio between residents and teaching faculty in residency program to appropriate level and substantiality in contents of hospital teaching rotation program should be needed. ????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????�.
关键词：Medical education;Educational measurement;Clinical competence;Internship and residency
