Standardized Patient Assessment

Funding by the Macy Foundation more than a decade ago began the movement toward the use of standardized patients in clinical instruction. The initial studies, conducted by a consortium of six medical schools, proved so successful that today more than half the medical schools in the United States require students to participate in examinations using standardized patients to demonstrate their mastery of core clinical skills. In addition, students graduating in 2005 will take a standardized patient examination as part of the United States Medical Licensing Examination (USMLE) step two clinical skills examination.

Despite the now-extensive use of the standardized patient approach, the impact of the Macy Consortium’s work on the teaching of clinical skills is unknown. This grant will support a nation-wide evaluation of the status of clinical skills assessment. The first phase involves a quantitative survey of curricular deans at all U.S. allopathic medical schools, followed in phase two by individual interviews with clinical educators from schools of medicine with established programs for standardized patient examinations.

This second phase will focus on standard setting and remediation. In the final phase, curricular deans will be surveyed again to assess the impact of the introduction of standardized patient clinical skills assessment as part of the licensing examination.

The study will also provide an evaluation of the Macy consortia grants to determine the long-term impact.