Clinical performance assessment using standardized patients: a primer

Area of Science:

• Medical Education
• Clinical Skills Assessment

Background:

• Standardized patients (SPs) are increasingly utilized in medical education for performance assessments.
• Clinical performance assessments (CPAs) encompass Objective Structured Clinical Examinations (OSCEs) and Simulated Clinical Encounters (SCEs).

Purpose of the Study:

• To evaluate the reliability and validity of standardized patient-based clinical performance assessments.
• To explore the application of OSCE and SCE formats in family medicine education.

Main Methods:

• Review of existing literature on standardized patient-based exams.
• Analysis of reliability and validity studies for CPAs.
• Discussion of OSCE and SCE formats in the context of medical training.

Main Results:

• CPAs demonstrate both reliability and validity in assessing medical students.
• Longer assessments generally yield higher reliability; rater and case specificity impact reliability.
• Validity studies confirm expected performance differences and correlations with other measures.

Conclusions:

• Both OSCE and SCE formats are valuable for medical education, assessing different skills.
• SP-based exams can evaluate basic skills and higher-level thinking, but concepts like continuity of care are challenging.
• Collaboration among family medicine educators is recommended to enhance SP-based assessments.