【摘要】 目的：探讨改革的实施效果。方法：回顾性研究。以2013—2019级临床医学专业学生为研究对象，以国家水平测试成绩作为主要效果评价指标，采用非参数检验进行统计分析。结果：理论考试成绩中位数从74分升至80分，理论考试通过率和临床医学模块掌握率全国排名百分位升至100。技能考试成绩呈显著提高(P<0.001)。SP的引入显著提升了体格检查成绩；Mini-CEX和DOPS的实施与理论和技能成绩的全面提升密切相关；OSCE的增设强化了临床操作技能。结论：基于米勒胜任力模型考核评价体系，有效促进了医学生临床思维与临床技能的协同发展，显著提升了学生在国家统一水平测试中的表现。该改革路径为深化CBME提供了实证依据与实践参考。更多还原

【Abstract】 Objective: To investigate the effectiveness of a Competency-Based Assessment System during the clinical stage. Methods: A retrospective study was conducted. Students from the 2013—2019 cohorts of the five-year clinical medicine program were included as research subjects. The National Clinical Medicine Proficiency Test scores served as the primary outcome measure. Statistical analysis was performed using non-parametric tests. Results: The median score on the theoretical exam increased from 74 to 80 points. The national percentile rankings for both the theoretical exam pass rate and the mastery rate of the clinical medicine module rose to the 100th percentile. Clinical skill exam scores showed a significant improvement(P<0.001). The introduction of Standardized Patients(SP) significantly enhanced physical examination performance. The implementation of Mini-Clinical Evaluation Exercise(Mini-CEX) and Direct Observation of Procedural Skills(DOPS) was closely associated with comprehensive improvements in both theoretical and skill scores. The addition of Objective Structured Clinical Examination(OSCE) further strengthened clinical procedural skills. Conclusion: The assessment system based on Miller’s competency pyramid effectively fostered the synergistic development of clinical reasoning and practical skills among medical students, leading to a marked improvement in their performance on the national standardized exam. This reform pathway provides empirical evidence and practical reference for deepening competency-based medical education(CBME) implementation.更多还原