ECADES OF RESEARCH HAVEconfirmed that poor skills in patient communication are associated with lower levels of patient satisfaction, higher rates of complaints, an increased risk of malpractice claims, and poorer health outcomes. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Medical schools have responded by incorporating training in patient communication and clinical skills into the curriculum. However, these skills were not systematically evaluated, nor was a minimum level of proficiency required for medical licensure. 17 To address this problem, licensure reforms were undertaken in North America. 18 The Medical Council of Canada (MCC) (1993), 19 the Educational Commission for Foreign Medical Graduates (1998), 20 and most recently the United States Medical Licensing Examination (USMLE) ( 2004) 21 have all introduced a clinical skills examination (CSE)-a nationally standardized assessment of patient-physician communication, clinical history taking, and examination skills-as a requirement for licensure. All US and Canadian medical For editorial comment see p 1057.

Doctor scores on qualifying examinations are significant predictors of quality-of-care problems based on regulatory, practice-based peer assessment.

Better clinical decision-making and data collection skills and early modifications in therapy improve persistence with antihypertensive therapy.

Of 3000+ raters, fewer than 0.3% have been identified as being extreme using the proposed criteria. Rater performance is being monitored on a regular basis, and the impact of these raters on candidate results will be considered before results are finalised. Extreme raters are contacted by the organisation to review their rating style. If this intervention fails to modify the rater's scoring pattern, the rater is no longer invited back. As more data are collected the organisation will assess them to inform the development of approaches to improve extreme rater performance.

PurposeProgress testing is an increasingly popular form of assessment in which a comprehensive test is administered to learners repeatedly over time. To inform potential users, this scoping review aimed to document barriers, facilitators, and potential outcomes of the use of written progress tests in higher education. MethodThe authors followed Arksey and O'Malley's scoping review methodology to identify and summarize the literature on progress testing. They searched 6 databases (Academic Search Complete,