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Clinician and simulated patient scoring - the psychometrics of a national programme recruiting dentists to DF1
1University of Birmingham, College of Medical and Dental Sciences, Edgbaston, Birmingham B15 2TT.
Introduction:
In 2012 a national, standardised approach was taken to UK Dental Foundation 1 recruitment. Prior to that recruitment method was at the discretion of individual Deaneries. The new national system is interactive, including simulated patients to see how applicants perform in a clinical communication context. A question was whether simulated patient scores could/should be awarded as well as clinicians' scores. This paper presents score data collected in the first round of national DF1 recruitment centres, with focus on how clinical examiners and trained simulated patients rated applicants.
Method:
At the live recruitment events across four national centres score data were collected from observing clinical assessors and simulated patients on the communication station. On this occasion only the clinician awarded scores 'counted', but all simulated patients completed marking sheets to enable the process to be evaluated. Data were retrospectively analysed to test the hypotheses that there would be no significant scoring differences between centres and that inter-rater reliability, by applicant, between paired clinicians, and between clinicians and simulated patients would be strong.
Results:
Results showed encouraging consistency between assessors, with some differences between centres. Clinicians were more likely to offer a borderline score. In communication analyses empathy had the weakest correlation with the overall score, while professional attitude had the strongest correlation. Data supported the hypothesis that trained simulated patients can be considered as assessors. Their future inclusion offers candidates a dual perspective (clinical and non-clinical) on performance, and saves clinical time.Discussion Simulated patients scored consistently and value can be added by including different perspectives in interactive assessment. Robust training is needed in all assessor training.
Conclusion:
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.