Computer-based pre-clinical assessment [Computer-gestütztes Prüfen im 1. Studienabschnitt]

[english] According to the new German Federal Regulations for medical education, the written preclinical national boards examination ("1. Staatsexamen") should focus on - a horizontal integration of all subjects - a vertical link through clinical references and - problem-oriented terms of reference. To fulfill these requirements, the question context has to be changed while the question format "single best answer" is mandatory and unchanged by the new regulations. Within the framework of this study an examination was developed, with respect to these guidelines. It consisted of one-best answer multiple-choice questions, which related to five clinical syndromes. In one version of the exam the questions were put together randomly without reference to the underlying syndromes. In the second version the exercises were ordered according to the syndromes. Every block of questions was coupled with a case description that included the typical manifestation of the syndrome through the presentation of a patient's case. The exercises could be solved independently of each other and they did not contain any clues to the correct solutions. The examination was carried out on the computer based system CASUS. An important issue in this study was the question of whether the embedding of examination exercises in a clinical context has an effect on the results of the examination. It was shown that the set up of the examination had no influence on the examination results. Another question concerned students' acceptance of learning with and taking an examination on a computer. Regarding learning with a computer, the students' acceptance was high, whereas they were more reluctant to accept computerized examinations. [german] Nach der neuen Approbationsordnung muss das erste Staatsexamen folgende Charakteristika aufweisen: - eine interdisziplin re F cherintegration - klinische Bezüge - und Problemorientierung. In der vorliegenden Studie wurde eine Prüfung entwickelt, die diese Forderungen umgesetzt hat. Sie bestand aus Einfachauswahl-MC-Fragen, die sich auf fünf verschiedene, klinische Syndrome bezogen. In einer Version waren die Fragen zuf llig angeordnet, in der anderen waren die Fragen dem jeweiligen Syndrom zugeordnet. Jeder Fragenblock wurde mit einer Fallvignette eingeleitet, die einen Patient mit den typischen Manifestationen des Syndroms beschrieb. Die Fragen konnten unabh ngig voneinander beantwortet werden und enthielten keinerlei Hinweise auf die richtigen Antworten. Die Prüfung wurde mit dem computerbasierten Lernsystem CASUS durchgeführt. Ein Ziel der Studie war es