Six years of comprehensive, clinical, performance-based assessment using standardized patients at the Southern Illinois University School of Medicine

Abstract

By the end of 1990-91, the Southern Illinois University School of Medicine had had six years of experience with comprehensive, performance-based examinations of senior medical students' levels of clinical competence; this report assesses the psychometric aspects of the six examinations given during that period. The examinations were aimed at determining the students' readiness for postgraduate training. Compared with other clinical performance-based assessments that use standardized patients (SPs), these examinations had two important and unique features: (1) the examinations assessed a comprehensive range of clinical skills and reasoning; and (2) they approximated the challenges of real clinical practice wherein a practitioner's skills need to be orchestrated and prioritized in order to meet the challenges of the case encountered. Each year, the performance-based assessment given was an intensive clinical examination requiring each student to work up 13 to 18 SP problems over a three-day period. To administer an examination to an entire class of students took three weeks. Because all students after the first year of administration (1986) were required to pass these examinations, the fairness of test design and scoring and the setting of performance standards for the examinations became important issues for the faculty. The results, accumulated over six years and based on a total of 6,804 student-patient encounters involving 405 students, indicate that this kind of clinical performance-based examination can discriminate a wide range of students' clinical performances. The results provide evidence for the examinations' test security, content validity, construct validity, and reliability.

Pharmacy Students' Preferences for Various Types of Simulated Patients

“…2 Standardized patients provide a standard assessment tool that can be used to evaluate pre-established educational objectives. 3,4 The performance of medical students on standardized patient assessments has been correlated with performance during the first year of residency. [5][6][7] In addition, standardized patients provide a consistent medium through which medical students can apply, practice, and develop clinical skills.…”

“…Current doctor of pharmacy (PharmD) curricula also commonly engage pharmacy students in learning and assessment activities involving standardized or simulated patients based on similar education benefits. [8][9][10][11][12][13] While the benefit of using simulated patients has been well documented in both the medical and pharmacy education literature, [2][3][4][5][6][7][8][9][10][11][12] less attention has been focused on the comparison of various simulated patient types. (Note: this manuscript uses the term simulated patient, which is more specific to people who are trained to represent a patient with a history and laboratory profile, rather than the broader term of standardized patient.…”

Necessity of introducing postencounter note describing history and physical examination at clinical performance examination in Korea

“…(Table III). 병력청취 (p=0.0014), 의사예절 Rutala et al, 1991;Stillman et al, 1991;Vu et al, 1992,;Williams et al, 1992). …”

“…환과 이에 따르는 시험성적의 변화는 거의 없는 것 으로 알려져 있다 (Rutala et al, 1991;Vu et al, 1992). 전공의 대상 CPX에서는 초반부에 시험을 치 른 수험생이 후반부에 시험을 치른 수험생보다 유 리했다는 증거를 발견하지 못했다 (Stillman et al, 1991).…”

“…수험생간 문제의 사전 유출을 해결하기 위해 OSCE와 슬라이드 시험 혹은 지필고사를 직렬적으 로 연결하여 운영하기도 한다. 남일리노이의대에서 는 매년 50~70%씩 새로운 문제로 바꾸어 임상실습 종합평가로서 표준화 환자를 이용한 수행시험을 시 행하고 있다 (Vu et al, 1992). …”