The effect of task exposure on repeat candidate scores in a high-stakes standardized patient assessment.

Background: Failing candidates often make multiple attempts on licensure and certification examinations. For performance-based assessments, where available test material is often limited, overlap in examination content is frequently inevitable.

Purpose: The purpose of this study was to investigate the performance of repeat candidates, both on new and exposed material, on a standardized patient clinical skills assessment.

Methods: Analysis of variance techniques were used to investigate the longitudinal performance of repeat candidates. Score differences for the second test session were analyzed as function of prior exposure to assessment materials.

Results: Although the performance of candidates improved between the first and second assessment, score increases could not be attributed to the random exposure of examination material.

Conclusions: The exposure of case content on clinical skills examinations does not appear to provide any advantage, or disadvantage, to repeat test takers. This finding, although based on average scores for repeat examinees, suggests that valid assessment scores can be obtained even if there is some overlap in assessment content.