Effect of varying amounts of feedback on standardized patient checklist accuracy in clinical practice examinations

Background: The accuracy of standardized patients (SPs) as recorders is an ongoing concern in medical education. Consistent feedback from an expert ob server during a clinical examination might enhance the SPs' accuracy in com pleting checklists. Purpose: To determine the frequency of feedback necessary to maximize SP ch ecklist accuracy. Method: Student checklists were completed after each enco unter by the SPs. Varying levels of feedback were given to SPs by their tra iners. To determine checklist accuracy level, multiple reviewers developed an answer key for each student encounter studied. Two hundred ninety-eight encounters were examined for agreement among 6,566 checklist items. Results: Random feedback resulted in significantly higher levels of SP accu racy than no feedback. There was no significant difference between random a nd constant feedback. Conclusions: This study suggests that random feedback given to SPs is suffi cient to enhance SP checklist accuracy and should be part of implementation protocols in all required clinical performance examinations.