Clinical skills assessment with standardized patients

Abstract

Previous projects (Combell I & II) to assess clinical skills were conducted in medical schools in Catalonia, in order to introduce a model of such an assessment using standardized patients (SP). The aim of this study (Combell III) was to measure selected characteristics of our model. Seventy-three medical students in the final year at the Bellvitge teaching unit of the University of Barcelona participated in a clinical skills assessment (CSA) project that used 10 SP cases. The mean group scores for the four components of clinical skills for each day of testing were studied, and ratings for each student in the 10 sequential encounters were checked. The study also compared the clinical skills scores with their academic grades. The total case mean score (mean score of history-taking, physical examination and patient notes scores) was 51.9%, and the mean score for communication skills was 63.6%. The clinical skills scores over the 8 testing days showed no day-to-day differences. The study did not find differences among the sequential encounters for each student (training effect). There was a lack of correlation between clinical skills scores and academic grades. The project demonstrated the feasibility of the method for assessing clinical skills, confirmed its reliability, and showed that there is no correlation between scores with this method and academic examinations that mainly reflect knowledge.

Gender, sequence of cases and day effects on clinical skills assessment with standardized patients

“…Medical professors using keywords evaluated the clinical reports made by the students. More details of the examinations can be found in the published reports of one of the medical schools involved 1 …”

“…Clinical skills assessment (CSA) with standardized patients (SP) is one of the more comprehensive and accepted methods of realistic professional testing. CSA was introduced in Spain in 1994 1 . The evidence from other countries shows that, although the technique is powerful, objective complementary research should be continually conducted in order to improve the understanding of and knowledge about this methodology 2 .…”

Using standardised patients to measure physicians' practice: validation study using audio recordings

“…5 6 Although standardised patients have long been used to evaluate medical students and residents, their use in actual clinical settings is relatively new 7. In medical education standardised patients are introduced into a carefully controlled setting: typically they are directly observed, work in a designated room, and evaluate students from a single school or training programme 8. Under these controlled conditions standardised patients have been validated to ensure that they perform consistently.…”

A Clinical-Skills Examination for Medical Students?

“…3 The data also show that some U.S. medical students are capable of passing their clinical rotations without adequately developing these skills 4 and that this inadequacy may contribute to the likelihood of being sued for malpractice. 5 The data do not show that requiring students to take a clinical-skills examination for approximately $1,000 (a total of $3,000 with travel and interest) will prevent this kind of inadequacy.…”