Effects of Case Characteristics on Encounter Time in a High-Stakes Standardized Patient Examination

Abstract

Data from national surveys indicate that patient characteristics could influence the time spent by physicians interviewing and assessing patients. The purposes of this investigation were to gather information regarding the relationship between encounter time and case characteristics for simulated clinical encounters and to provide evidence that the time provided to gather data was adequate. Timing data was extracted from United States Medical Licensing Examination Step 2 Clinical Skills. To test the relative effects of case characteristics on encounter time, an analysis of variance was conducted with encounter time as the dependent variable and case characteristics as the independent variables. Mean encounter times were computed based on the case characteristics. Station format (history only, history and physical examination, telephone cases) predicted the most variance in encounter time (16%). The extent to which examination content is balanced from administration to administration ensures a mix of cases that provides adequate time limits for examinees.