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The founding documents of the United States Medical License Examination™ (USMLE™
call for inclusion of a test of clinical skills when such a test could be shown to be valid, reliable, and feasible. The NBME was charged with conducting appropriate research studies. The NBME has been developing a clinical skills examination employing "patients" trained to present standardized clinical situations; NBME research indicates that a standardized patient (SP) examination adds a valuable dimension to the licensure examination.
In January 1999, the governing body of the USMLE, the Composite Committee, reaffirmed its commitment to include in the USMLE an examination of clinical skills using standardized patients. The Federation of State Medical Boards took similar action in April 1999. At its 1999 Annual Meeting, the National Board of Medical Examiners directed NBME staff to complete investigations necessary for implementation and approved final field tests of the examination.
Having concluded that such an examination would be valid and reliable, the NBME is now proceeding with final studies of logistics for the examination. The examination will probably consist of a minimum of 10 scored cases; examination centers will be designed to permit administration of a 12- or 14-case examination if ongoing research indicates that a longer examination is necessary. Each encounter will last approximately one-half hour, and the overall duration of the examination will be 5 to 6 hours.
Data gathered by the NBME, the Educational Commission for Foreign Medical Graduates, and the Medical Council of Canada indicate that standardized patient examinations identify a different cohort of candidates than multiple choice examinations of cognitive skills. The NBME expects that initial failure rates on the examination for students in medical schools accredited by the Liaison Committee on Medical Education will be similar to those on Steps 1, 2 and 3 of the USMLE. Ultimate failure rates will be lower.
The NBME is reviewing several examination delivery models. One possible model consists of a core of five to seven test centers located at strategic locations throughout the country operating continuously throughout the year. The feasibility of supplemental test sites at medical schools is being evaluated.
If everything goes well, implementation could occur in mid-2004 for the students graduating in 2005, but further approvals of the implementation will be required by the NBME and FSMB.
call for inclusion of a test of clinical skills when such a test could be shown to be valid, reliable, and feasible. The NBME was charged with conducting appropriate research studies. The NBME has been developing a clinical skills examination employing "patients" trained to present standardized clinical situations; NBME research indicates that a standardized patient (SP) examination adds a valuable dimension to the licensure examination. In January 1999, the governing body of the USMLE, the Composite Committee, reaffirmed its commitment to include in the USMLE an examination of clinical skills using standardized patients. The Federation of State Medical Boards took similar action in April 1999. At its 1999 Annual Meeting, the National Board of Medical Examiners directed NBME staff to complete investigations necessary for implementation and approved final field tests of the examination.
Having concluded that such an examination would be valid and reliable, the NBME is now proceeding with final studies of logistics for the examination. The examination will probably consist of a minimum of 10 scored cases; examination centers will be designed to permit administration of a 12- or 14-case examination if ongoing research indicates that a longer examination is necessary. Each encounter will last approximately one-half hour, and the overall duration of the examination will be 5 to 6 hours.
Data gathered by the NBME, the Educational Commission for Foreign Medical Graduates, and the Medical Council of Canada indicate that standardized patient examinations identify a different cohort of candidates than multiple choice examinations of cognitive skills. The NBME expects that initial failure rates on the examination for students in medical schools accredited by the Liaison Committee on Medical Education will be similar to those on Steps 1, 2 and 3 of the USMLE. Ultimate failure rates will be lower.
The NBME is reviewing several examination delivery models. One possible model consists of a core of five to seven test centers located at strategic locations throughout the country operating continuously throughout the year. The feasibility of supplemental test sites at medical schools is being evaluated.
If everything goes well, implementation could occur in mid-2004 for the students graduating in 2005, but further approvals of the implementation will be required by the NBME and FSMB.
