Assessing the acquisition of core clinical skills through the use of serial standardized patient assessments

Purpose. Students in many medical schools now undergo multiple standardized -patient-based assessments. In this study, the authors examine the ability of such serial assessments to detect interval learning. Method. Twenty-one students from the University of California, Irvine, Coll ege of Medicine, class of 1999, underwent a clinical skills appraisal after three months of their third-year instruction. After nine months, all 89 me mbers of that class completed an OSCE. Subsequently, all 87 students in the class of 2000 also completed clinical skills assessments after their third and ninth months of third-year instruction. All of these exercises include d identical or similar stations measuring history, physical examination, an d communication skills. Communication skills were measured somewhat differe ntly during some of the exercises, using checklists that were either "conte nt-" or "process-"oriented. The authors compared the performances for all g roups. Results. Both classes demonstrated significant improvement in physical exam ination performance, while their history performances remained unchanged. A ccording to the assessments, their communication skills deteriorated over t he course of their third-year instruction. Repeated exposures to similar or identical cases on title serial assessments did not impact the students' p erformances. Both content- and process-oriented measures of communication s kills yielded highly similar results. Conclusions. Serial assessments using standardized patients can detect inte rval changes in performance that are independent of repeated exposures to s imilar or identical cases. Changes detected using this approach may have im portant curricular implications.