Widening the lens on standardized patient assessment: What the encounter can reveal about the development of clinical competence

The standardized patient (SP) examination is used in a majority of medical schools to test clinical skills. This examination usually yields both numer ical ratings of clinical skill and narrative comments by patients or observ ers, yet most empirical studies of SP assessment focus on the numerical rat ings only. This quantitative focus can lead to a narrow conceptualization o f the nature and development of clinical competence. The authors suggest th at in addition to utilizing SP numerical ratings, medical educators also us e the rich qualitative material produced in the SP examination (e.g., patie nt comments, videotapes of the examination) to explore students' developmen t of clinical competence, which involves the purposive integration of basic science, technical skill, empathy, communication, professional role, and p ersonal history.