Realist evaluation uncovers conditions affecting assessments by simulated patients in clinical exams, implying improvements for training and collaboration.
SP judgments in high-stakes OSCEs are complex and context-dependent. This programme theory provides an explanatory account of how SP judgments are produced and identifies conditions that support or undermine assessment. The findings offer practical implications for assessment design, SP training and faculty-SP collaboration to strengthen the use of SPs as assessors in high-stakes clinical examinations.
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El-Sherif et al. (2026) studied this question.
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