客觀結構式臨床測驗 (Objective Structured Clinical Examination, OSCE) 是目 前醫學教育用以評估學生臨床技能的重要方法。本研究目的乃以先驅測試的方式， 以腦中風 (Cerebral Vascular Accident, CVA) 個案之布朗斯壯動作能力評量為例， 檢驗CVA 之OSCE 檢核表，期望產生具備信效度的項目。本研究專家效度分析採 用項目內容效度指標和量表內容效度指標。主考官間信度分析採用加權卡帕係數、 皮爾森相關係數和配對樣本t 檢定。並採用Cronbach’ s α 係數進行試題內部一致 性檢定。共有5 位專家、2 位主考官和32 位職能治療學系大三學生參與。結果指 出，內在一致性分析方面，透過專家效度之建議，刪除生活史和居家環境之後， 已獲得良好之內在一致性。考生之表現，除了試題5（生理狀態）之外，皆高於 1.00 分（滿分2 分）。在所有呈現顯著差異之試題中，考官間評分一致性僅達到 一般可接受之範圍，而考官評分之間達到中度之正相關。整體而言信效度方面需 要再加強改善。本文建議未來可增加考生版檢核表之結構性、具體化溝通項目的 檢核標準、和選擇有詳細操作定義的評量考題等。期望透過OSCE 的評量，得以 提升學生臨床技能與學校端之教學品質，協助學生能夠順利銜接學校、實習與就 業之過渡期。

Objective Structured Clinical Examination (OSCE) is a method of testing students’ clinical skills in medical education. This preliminary research aimed to construct a checklist for Cerebral Vascular Accident (CVA) OSCE based on the Brunnstrom recovery assessment stages. The reliability and validity of the CVA OSCE checklist were examined. The item-content validity index and content validity index for scales were used for expert validity analysis. The weighted Kappa coefficient, Pearson correlation coefficient, and paired t test were used for reliability analysis. Cronbach’s α was used for internal consistency analysis. Five experts, 2 testers, and 32 students were recruited. The results indicated that, after deletion of the items of “life style” and “home environment”, the internal consistency was good. All of the students exhibited good performance in spite of the item of “physical attitude”. Most of the items generating significant results appeared to have acceptable inter-rater reliability. Based on the findings, it is recommended that structured testing for students be added, that concrete testing guidelines be developed for communication items, and that detailed procedures be developed for select testing topics. It is expected that the gap between clinical practice and school education can be diminished through OSCE.