Performance-based Examination Research Articles

Sequential testing with a performance-based examination using standardized patients

Sequential testing with a performance-based examination using standardized patients

Sequential Testing with a Performance-based Examination Using Standardized Patients

Sequential Testing with a Performance-based Examination Using Standardized Patients

The Interaction of Student Gender and Standardized-patient Gender on a Performance-based Examination of Clinical Competence

The Interaction of Student Gender and Standardized-patient Gender on a Performance-based Examination of Clinical Competence

Effect of Position-Within-Sequence on Case Performance in a Multiple-Stations Examination Using Standardized-Patient Cases

Several recent studies of multiple-stations examinations of clinical competence have found a "sequence effect," which refers to an observed improvement in performance across a sequence of examination cases, so that performance on stations encountered later in the sequence is significantly superior to that on stations encountered earlier. The present study was conducted to assess the possibility of a sequence effect in the multiple-stations performance-based examination given to senior medical students at Southern Illinois University School of Medicine. Unlike the previous studies, the present study assessed the sequence effect at the level of the individual case, the level at which the effect creates a serious problem for score interpretation. Analyses were performed on scores obtained from checklists completed by standardized patients and on scores to written questions following the patient encounter for each standardized-patient case for the classes of 1989 and 1990. In general, the results showed no improvement in case scores across successive cases in the examination. There was no evidence for a sequence effect on student examination performance.

Reliability and efficiency of components of clinical competence assessed with five performance-based examinations using standardized patients

The present study was conducted to provide in-depth information on the reliabilities of measures of the separate components of clinical competence (e.g. data collection, test interpretation, diagnosis, etc.) assessed by a performance-based examination consisting of standardized-patient cases administered to five classes of senior medical students at Southern Illinois University School of Medicine. In general, the reliabilities of the competencies as they were actually measured on the examination (using the number of cases on which each competency was actually measured) were small, with 54% less than 0.30 and 75% less than 0.40. For generalizability coefficients pooled across the five classes and projected to a common number of k = 10 cases, two of the nine competencies had reliabilities in the 40s, a third was close to 0.40, and the remaining six were in the low 20s. The number of cases needed for the competencies to achieve the recommended reliability of 0.80 ranged from 45 to 170 cases, with six of the nine competencies requiring over 100 cases to reach the 0.80 level. The low reliabilities of these measures of the components of clinical competence raise serious questions about using the scores as indicators of student performance.