Impact of an In-Person Versus Web-Based Practice Standardized Patient Examination on Student Performance on a Subsequent High-Stakes Standardized Patient Examination

Abstract

Background: Optimal methods of preparing students for high-stakes standardized patient (SP) examinations are unknown. Purposes: The purpose is to compare the impact of two formats of a formative SP examination (Web-based vs. in-person) on scores on a subsequent high-stakes SP examination and to compare students' satisfaction with each formative examination format. Methods: Clustered randomized trial comparing a Web-based module versus in-person formative SP examination. We compared scores on a subsequent high-stakes SP examination and satisfaction. Results: Scores on the subsequent high-stakes SP examination did not differ between the two formative formats but were higher after the formative assessment than without (p < .001). Satisfaction was higher with the in-person than Web-based formative assessment format (4.00 vs. 3.62 on a 5-point scale, p = .01). Conclusions: Two formats of a formative SP examination led to equivalent improvement in scores on a subsequent high-stakes examination. Students preferred an in-person formative examination to online but were satisfied with both.

We thank Bernie Miller and Jewel Smally for their help with examination administration, Mark Lovett for assistance with data analysis, Shanthi Colaco and Read Pierce for pilot-testing the narrated Web module, and the California Consortium for the Assessment of Clinical Competence for collaboration in development of the CPX examination.

Notes

^a n = 72.

^b n = 78.

^c n = 153.

∗ p < .001 for a multivariate analysis of variance across three groups. Post hoc tests indicated the two intervention groups each differed from the historical controls but did not differ from each other for history taking and physical examination.

∗∗p < .001 for an analysis of variance across three groups. Post hoc tests indicated the two intervention groups each differed from the historical controls but did not differ from each other.

^a 1 = poor, 2 = fair, 3 = good, 4 = very good, 5 = excellent.