Clinical teaching associates in medical education: the benefits of certification.

Background: Clinical teaching associates (CTAs) are human simulators who use themselves (i.e. their bodies and psyches) as an integral part of the teaching and assessing process. Increasingly, various CTAs are used in clinical education, for instance as stand-ins for clinical tutors or for high-stakes assessments.

Context: Four groups of people have a stake in the competence of CTAs: patients (as they are at risk, both currently, in the clinical situation, and in the future if learners develop inappropriate behaviours that they later exhibit in their clinical work); learners (as their interaction with CTAs may be in a high-stakes assessment); CTAs themselves (as they may wish to evidence their professional competence to new employers); and the organisations using them (as the reputation of the organisation depends on the competence of its faculty staff and graduates).

Innovation: We argue that the professionalisation and certification of CTAs becomes more important as the total risk rises, using a three-dimensional matrix of risk (for patients), stakes (for learners) and responsibility (for CTAs).

Implications: We suggest that the time is right for a colloquium to endeavour to agree standards for the certification of CTAs. This would be to the advantage of all stakeholders and would facilitate the use of CTAs in high-risk, high-stakes learning and assessment.