The management of patient encounter time in a high-stakes assessment using standardized patients

Objectives The purpose of this study was to gather information regarding the appropriateness of the length of time allotted for candidates to complete the history taking and physical examination tasks in a high-stakes standardized patient (SP) assessment. Design Data were collected on actual time used by 1548 examinees for each of their 10 standardized patient encounters, for which a maximum of 15 minutes was allotted, but not required. Setting The Clinical Skills Assessment Center of the Educational Commission for Foreign Medical Graduates (ECFMG), Philadelphia, Pennsylvania, USA. Subjects Graduates of foreign medical schools who are seeking ECFMG certification. Results The average time spent with the standardized patient was 13.3 minutes, suggesting that the 15-minute time limit was sufficient. A positive correlation was found between data-gathering scores and patient interview times. Candidates did tend to spend more time with SPs presenting with cases involving complex histories, as well as with cases of chronic conditions. Conclusions Candidate time use varied as a function of type of clinical encounter, providing additional evidence of the content validity of the Clinical Skills Assessment.