Stimmel Barry, Cohen Devra, Fallar Robert, Smith Lawrence
Graduate Medical Education, Mount Sinai School of Medicine, New York, New York 10029, USA.
Med Educ. 2006 May;40(5):444-9. doi: 10.1111/j.1365-2929.2006.02446.x.
The use of standardised patients (SPs) is now an integral component of the United States Medical Licensing Examination (USMLE). This new requirement has caused more schools to include SP examinations (SPEs) in their curricula. This study reviews the effect of prior experience with SPs in a medical school curriculum on SPE pass rates.
This study reviewed the mean scores and pass rates on a 4-station SPE, comparing the performance of 121 US medical school graduates (USMGs) with that of 228 international medical graduates (IMGs). The analysis of USMGs' performance was based upon whether the resident had had previous exposure to an SPE during medical school, while the analysis of IMGs' performance was based upon whether the IMG had taken the Clinical Skills Assessment (CSA) for certification by the Education Commission for Foreign Medical Graduates. A distinction was made between those who had received prior exposure at Mount Sinai School of Medicine's Morchand Center, where the cases utilised were identical to those of the SPE, and those who had gained exposure elsewhere.
Neither the mean scores of the IMGs and the USMGs nor the percentage who failed was significantly different relative to prior exposure to SPs.
Prior exposure to SPs does not appear to have a positive effect on subsequent performance on an SPE unless similar or identical cases are used. However, the type and site of prior exposure limited the influence of the review. In view of the increased use of SPEs in medical schools, the content of prior exposure needs to be more fully established.
标准化病人（SPs）的使用现已成为美国医师执照考试（USMLE）不可或缺的一部分。这一新要求促使更多学校将标准化病人考试（SPEs）纳入其课程。本研究回顾了医学院课程中对标准化病人的先前经验对标准化病人考试通过率的影响。
本研究回顾了一个四站式标准化病人考试的平均分数和通过率，比较了121名美国医学院毕业生（USMGs）和228名国际医学毕业生（IMGs）的表现。对美国医学院毕业生表现的分析基于住院医师在医学院期间是否曾接触过标准化病人考试，而对国际医学毕业生表现的分析则基于该国际医学毕业生是否参加了外国医学毕业生教育委员会认证的临床技能评估（CSA）。区分了那些曾在西奈山医学院莫尚德中心接触过标准化病人的人，该中心使用的病例与标准化病人考试的病例相同，以及那些在其他地方接触过标准化病人的人。
国际医学毕业生和美国医学院毕业生的平均分数以及不及格的百分比相对于先前接触标准化病人的情况均无显著差异。
除非使用相似或相同的病例，否则先前接触标准化病人似乎对随后的标准化病人考试表现没有积极影响。然而，先前接触的类型和地点限制了该综述的影响。鉴于医学院中标准化病人考试的使用增加，需要更全面地确定先前接触的内容。
