Ensuring the clinical competence of medical school graduates through standardized patients

• There are substantial problems with the clinical training provided to medical students and with the assessment procedure used by medical schools to ensure that students have acquired the clinical skills necessary for graduate medical education. These skills are not evaluated carefully nor systematically at any point in training or licensure. This article describes the use of standardized patients to help resolve some of these shortcomings. Standardized patients are nonphysicians highly trained to function In the multiple roles of patient, teacher, and evaluator while realistically replicating a patient encounter. They are effective teachers of Interviewing and physical examination skills. They can help to provide a controlled exposure to common ambulatory and difficult patient communication situations. Initial studies indicate the promise of this approach for ensuring the competence of medical school graduates. (Arch Intern Med1987;147:1049-1052)