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.