Clinician and simulated patient scoring – the psychometrics of a national programme recruiting dentists to DF1 training posts

Abstract

Simulated patients can usefully contribute to scoring in national dental recruitment centres. Lessons learned here can inform other dental assessments where stakeholders are already using, or considering using, simulated patients as assessors or co-assessors.

What is the value of simulated patient assessment in structured clinical examinations of undergraduate students, and how should it be used?

“…Structured clinical examinations such as OSCE are widely accepted globally as a valid and reliable form of assessment of clinical skills at level three of Miller's clinical competency pyramid 7,17 . However, the role of patients in summative assessment activities has not been adopted widely, and there are a variety of grading methodologies that can be used (including global ratings, checklists, open‐ended comments and rating scales) 9,10 …”

“…7,17 However, the role of patients in summative assessment activities has not been adopted widely, and there are a variety of grading methodologies that can be used (including global ratings, checklists, open-ended comments and rating scales). 9,10 Effective therapeutic communication of healthcare professionals play a fundamental role in patient experience, satisfaction, successful care outcomes, and reduced patient anxiety. [18][19][20] Authentic scenarios in OSCE provide opportunities for assessment of student performance, and patient feedback on student performance can be valuable in improving student communication skills and can be used as a reliable learning tool.…”

“…8,9 Studies in dental settings have found that patients tend to assess more leniently than clinicians and that fewer students fall into the borderline category-that is patients tend to make more definite satisfactory or unsatisfactory decisions. 10,11 Final-year dental students on the Bachelor of Dental Surgery (BDS) programme at our Dental school are examined using various different summative assessments, including the Integrated Structured Clinical Examination (ISCE). 12 The ISCE examination is generally similar to the traditional Objective Structured Clinical Examination (OSCE).…”

“…It is proposed that patients can be used in teaching and assessment as reliably as clinician experts can, provided they are suitably trained 8,9 . Studies in dental settings have found that patients tend to assess more leniently than clinicians and that fewer students fall into the borderline category—that is patients tend to make more definite satisfactory or unsatisfactory decisions 10,11 …”