Abstract: Objective To conduct a systematic analysis of a clinical surgery theoretical examination based on knowledge points,thereby providing a reference for establishing a scientific and comprehensive test paper analysis system.Methods Using the difficulty coefficient (P-value) and discrimination index (D-value) as indicators,a detailed evaluation was performed on 6 question types and 40 knowledge points from the"Clinical Comprehensive Course:Surgery "examination for the 2023 clinical medicine pilot class at Peking Union Medical College.Data were visualized using frequency distribution charts,radar charts,and scatter plots.Results A total of 35 examination papers were collected.The students'average score was (78.63 ± 7.58),with a pass rate of 100%.The overall difficulty coefficient of the examination paper was 0.79,and the overall discrimination index was 0.15.Among the 40 knowledge points,2(5.0%) were difficult,9(22.5%) were moderately difficult,and 29(72.5%) were relatively easy.Regarding discrimination,3(7.5%) knowledge points showed excellent discrimination,8(20.0%) demonstrated good or acceptable discrimination,and 29(72.5%) had relatively poor discrimination.Some knowledge pointse.g.," Benign Prostatic Hyperplasia"(P=0.26,D=-0.17)presented issues of high difficulty coupled with poor discrimination.A considerable number of knowledge points exhibited poor discrimination,indicating a need for corresponding adjustments.Conclusion Knowledge-point-based test paper analysis can provide references for optimizing question type design,thereby enhancing the scientific nature of assessments and offering a basis for teaching improvements.