The Efficacy of a Targeted Remediation Process for Students Who Fail Standardized Patient Examinations

Abstract

Background: Current remediation strategies for students failing standardized patient examinations represent poorly targeted approaches since the specific nature of clinical performance weaknesses has not been defined. Purpose: The purpose is to determine the impact of a specifically targeted clinical performance course required of students who failed a clinical performance examination. Methods: A month-long clinical performance course, targeted to treat specific types of clinical performance deficiencies, was designed to remediate students failing standardized patient examinations in 2007 (n = 8) and 2008 (n = 5). Participating students were assessed on pre- and postperformance measures, including multiple-choice tests that measured diagnostic pattern recognition and clinical data interpretation and clinical performance measures using standardized clinical encounters. Comparisons between average pre- and postintervention performance scores were computed using paired sample t tests. Results were adjusted for regression toward the mean. Results: In both 2007 and 2008, the mean preintervention clinical data interpretation and standardized patient examination scores were below the criterion referenced passing standard set for the clinical competency exam. In both years the mean postintervention scores for the participants were above the passing standard for these two examinations. Pre- and postintervention differences were statistically significant in both cases. Conclusions: This study provides insight into the reasons that students fail clinical performance examinations and elucidates one method by which such students may be successfully remediated.