Assessment of Uniqueness of Information Provided by Postencounter Written Scores on Standardized-Patient Examinations

The complete clinical encounter station uses two testing methods in the assessment of clinical competence: checklists completed by standardized patients (SPs) who record actions students performed on history and physical examination and written responses by students to a series of written questions designed to elicit findings they see as pertinent to the problem, their working hypotheses, their plans for laboratory findings, and their diagnoses and management plans. Given that the critical part of any SP station is the standardized-patient encounter and that the postencounter session needed for the student to answer the written questions increases the time required to administer an already lengthy examination, questions have been raised about the need for written questions in addition to SP checklists in the clinical encounter station. Thus it is important to determine if the written scores are providing additional, nonredundant information over and above that provided by the checklist scores. The results of this study showed only moderate overlap between the checklist and written scores. The mean checklist-written correlation across 83 SP cases was .13, and the mean correlation between the average checklist and written scores across six classes of medical students was.32. The mean of the correlations across the six classes, disattenuated for measurement error, was only .57. The results provide strong evidence that the written scores provide unique information, in addition to that provided by checklist scores.