A Standardized Patient Enrolled in Medical School Considers the National Clinical Skills Examination

The National Board of Medical Examiners' recent decision to include a clinical skills examination as part of the licensing requirements for U.S. medical graduates has generated widespread discussion about the role of standardized patients in medical education. The author demonstrates that while specific clinical skills can and should be integrated into the medical school curriculum, any assessment of these skills using interactions with standardized patients must allow for a fuller range of responses and immediate, multifaceted feedback (content, process, and patient satisfaction) than would be allowed in the proposed Step 2 Clinical Skills. The presence of a national examination would pressure medical schools to adopt the very limited model of patient-physician interaction favored by the National Board of Medical Examiners. In addition, the author argues that the cost of registering for the examination and traveling to one of the few test sites on borrowed money is not justified to verify skills that may be reliably assessed locally.