Case Specificity of Standardized-Patient Examinations

Abstract

The psychometric properties of nine separate components of clinical competence (e.g., data collection, diagnosis, and management) assessed with standardizedpatient cases were studied by Colliver et al. (1989). The findings of that study suggested the hypothesis that performance on a given component of clinical competence (e.g., data collection) would show less consistency when measured on different cases than would performance on different components (e.g., data collection, diagnosis, and management) measured within the same case. Thus, the purpose of the present study was to test this hypothesis. In general, the results supported the hypothesis. Specifically, generalizability coefficients were generally smaller for a given component across cases than for a given case across components. The recommendations implied by these results are: (a) More objective scoring methods are needed, and (b) The evaluation procedures for the components of clinical competence should be constructed as each case evaluation procedure is being constructed according to a clear conceptualization of the components which is developed in advance for all cases.