This system, the "Clinical Professional Practice Skills Testing System," is an application of computer science and technology in medical education. It is a software system primarily developed for assessing the practical skills of clinical medical students. The system mainly utilizes ADO technology, standard SQL, and an Access database. The main functional modules implemented on a web page include: a skills testing module, a scoring module, a grade management module, a test question management module, and a data maintenance module. Teachers can easily complete test paper grading and test question management (adding, deleting, modifying, and updating) by accessing the server-side website through a client browser, while students can also access the server-side website through a client browser to check their grades. System Analysis Preliminary System Investigation Currently, there are many examination and grade management system software programs, some of which are excellent. However, these programs need to cater to the majority of users, so their functions are generally generalized, and the systems are often very large, failing to meet the specific requirements of clients and often requiring redevelopment. Our college is a medical school, and the requirements of teachers and students are simplicity and ease of use, operable via a browser. Therefore, the developed software should operate on a web page. [align=center]Figure 2: System Functional Module Structure Design[/align] According to the survey, teachers typically use two methods to record grades. One is using an attendance sheet, recording each grade after the student's name and calculating the total and average scores using a calculator. Teachers reported that while this method is simple, it has many drawbacks. For example, calculating the average and total scores is very cumbersome, requiring adding each score individually with a calculator. Also, modifying student grades involves drawing and marking on the sheet. The second method is using Excel. Students' data is first entered into the computer, and then grades are recorded on a workbook. Calculating the total and average scores is very convenient, but it also has shortcomings. For example, teachers frequently use this file at home, in the classroom, or in the office, inevitably requiring daily copying, which increases the risk of virus infection and file loss. Most importantly, it lacks synchronous updates; files created in the classroom must be copied back to the office and overwritten. This is especially tedious and troublesome when medical students undergo skills assessments. Developing software that overcomes these shortcomings could significantly improve teachers' work efficiency. System Feasibility Analysis The software knowledge involved in this software is relatively simple, but with proper design and combination, it can still achieve rich and practical effects. Using ASP objects combined with SQL statements, it is possible to open and close the Access database, and perform operations such as adding, deleting, modifying, and updating data. The Access data access page allows teachers and students to access the database via a web page. The school has an independent server, and the software can be built on the existing web service for teachers and students to access and use. This system is based on a web page, and the school's teachers and students already have internet browsing knowledge; they can master the operation of the web page without training. This software system is used internally within the institution and does not involve any legal issues. System Design Software System Operating Environment ■ Client Operating System: WINDOWS 98; WINDOWS 2000; WINDOWS XP ■ Operating Platform: VISUAL Basic 6.0 + Access2000 Web Page Processing Teachers input student information and test question bank through the web page, write the data into the database, and students can query the processed and displayed score information through the web page (see Figure 1). System Functional Module Structure Design See Figure 2. Database Structure Design This system uses Access 2000 as its Database Management System (DBMS). A new database named jncsh.mdb is created in Access. The data tables and their corresponding functions in the jncsh.mdb database are shown in Table 1. System Functions This system consists of five functional modules provided on the main interface: Skill Testing, Scoring, Grade Management, Question Bank Management, and Data Management. Note: Each functional module can be managed by clicking the function buttons on the main interface or through menu operations. Question Bank Management Module The question bank system is the most important and also the most challenging component. The question bank here is defined narrowly, consisting of several independent questions. These materials are the core confidential information of the testing system, and security is paramount. Furthermore, to facilitate effective management of this information and enable rapid retrieval and use, the questions should be coded and certain parameters should be set, such as the scope of the test paper, the target audience, the frequency of use, the difficulty level, and the discrimination factor. The management of the question bank includes operations such as question entry and editing (including adding, deleting, and modifying). The question bank includes modules for medical history taking, case analysis, auxiliary result interpretation, and physical examination. These are accessed via command buttons on the question module selection window (shtgl) interface, which open the medical history taking question entry and editing window (bshcjct), case analysis question entry and editing window (blfxct), and auxiliary result interpretation question entry and editing window (fzhjgpdct) to manage the question bank (i.e., operations such as entering, adding, deleting, and modifying questions), ensuring real-time updates. Data Management Function Module Main Objectives: ■ Real-time import and export of examinee information and related data files. ■ Prevention of data loss and corruption, timely organization, and convenient retrieval. The data management module implements the following functions: It performs data synchronization and copying, system data backup and cleanup, and system log viewing. Data synchronization and copying not only ensures the uniformity and completeness of candidate data but also enhances security. Furthermore, through data maintenance, it achieves high data integration, optimizes existing data, and ensures timely data updates through basic data downloads and real-time data uploads, facilitating data statistics and queries, and improving the work efficiency and quality of teachers and related personnel. Data backup: Regular data backup and organization. Data recovery: Setting and adjusting various initial parameters and policy parameters of the system, and performing regular recovery. Skills Testing Function Module Main Objective: Based on providing the most suitable human-computer interaction, the module presents the assessment items (questions, assessment elements) on the computer screen, allowing test takers or assessors to answer questions or perform operations according to computer prompts. This realizes the application of computers in clinical medical education, standardizing and regulating medical education, and improving the work efficiency and quality of teachers. Functionality: ■ Assessment Modules: This system has four assessment modules, including: medical history taking assessment module, case analysis assessment module, auxiliary result interpretation assessment module, and physical examination (including major and minor physical examinations). ■ Assessment Methods: Divided into theoretical knowledge assessment and practical skills assessment. ■ Assessment Format: Assessment can be conducted on a computer or in a laboratory. ■ Question Types: This testing system includes four question types: fill-in-the-blank, true/false, multiple choice, and short answer. The computer-based assessment operation process is illustrated below: Click "Skills Test" → Candidate identity verification → Login → Extract questions → Exam → Submit. (Code for submission omitted.) Scoring Function Module: A scoring system is needed when test questions in the testing system require comprehensive evaluation conclusions. Its main function is to manage and score exam results. If the test paper contains objective questions, such as multiple choice and true/false questions, the system directly scores and converts them. For subjective questions, such as case analysis questions, essay questions, and some operational assessment content, teachers or examiners score manually. The system can also modify the automatically scored results and add comments. Grade Management Function Module: The main functions of the grade management module are to input, modify, browse, query, and statistically analyze grade information. This includes defining exams, the percentage of students achieving excellent grades, the pass rate, score ranges, and the highest score. Finally, it calculates students' final grades and provides various statistical information to administrators and teachers. Teachers and administrators of relevant courses maintain the grades, which are subject to strict time limits. For example, after a certain period, teachers cannot modify student grades; if modifications are necessary, they can only be made through an administrator, who must record the modification results and reasons in detail. Network users with grade management access can input and output grade-related information, such as printing student report cards, individual subject scores, semester grades, and scores from previous exams. Different user roles have different access to exam information, and exam information can be published online for users with query permissions (such as students and parents) to view and query. End A skills testing system is a system for acquiring, processing, storing, and using information; therefore, broadly speaking, it is a Management Information System (MIS). However, here we are referring to the clinical professional practice skills testing system as a system with a certain internal structure and independent functions. Simply put, it is a database with a wide range of information, including the examinee's basic information (provided during registration), the examinee's test scores, and relevant assessments. Web-based examination and grade management systems are still a relatively new concept in China. Researching web-based examination and grade management systems will adapt to the transformation of traditional teaching management to a modern examination and grade management model, better serving modern distance education, and has broad development prospects, and is bound to achieve significant progress in the future.