Standardized patients: a long-station clinical examination format

Area of Science:

• Medical Education
• Assessment in Health Professions Education
• Family Medicine Training

Background:

• Assessing clinical performance is crucial for medical education.
• Long-station clinical performance examinations (CPE) are used in family medicine clerkships.
• Evaluating the reliability and validity of these assessments is essential.

Purpose of the Study:

• To assess the reliability and validity of a long-station clinical performance examination in family medicine.
• To identify sources of variability in student performance, specifically station, case scenario, and examiner effects.
• To compare findings with short-station examination formats.

Main Methods:

• Analysis of data from 304 students over 20 periods of a 4-week family medicine clerkship examination.
• Statistical examination of station, case scenario, and examiner effects.
• Comparison of results with short-station examination formats.

Main Results:

• A significant examiner effect was identified as the primary source of score variability.
• No significant differences were found in student performance based on station or case scenario.
• Scores on the CPE demonstrated correlation with other clinical performance measures, supporting construct and criterion-related validity.
• Gaps were identified in the examination's content coverage relative to clerkship objectives.

Conclusions:

• Examiner variability is a key factor influencing reliability in this family medicine clinical performance examination.
• While construct and criterion-related validity are supported, content validity needs improvement.
• Ongoing efforts include examiner training, standardized case scenarios, and developing new cases to enhance reliability and validity.