The Assessment of Clinical Skills: Thinking Outside of the Box Jessica Salt, MD MBE FACP Medical Director, Director of Patient Note Program Clinical Skills Evaluation Collaboration Agenda • Background: Overview of USMLE Step 2 Clinical Skills Exam • Factors to consider when building a clinical skills assessment • Examples USMLE Step 2 Clinical Skills Exam • Required for licensure in the United States • Examinees perform 12 Standardized Patient (SP) encounters – 15 minute focused H&P – 10 minute patient note • Examinees are given 3 scores: – Integrated Clinical Encounter – Communication and Interpersonal Skills – Spoken English Proficiency • 35,000 examinations per year Many things contribute to a standardized exam • Cases developed by national academic faculty and experienced internal staff • Case performance pretested and monitored during live exam • Limited number of testing centers • SPs undergo standardized training and QC • Board Certified physicians undergo standardized training and QC to rate the patient notes • Psychometric analysis (reliability, validity) Limitations • Time • Cost • Inconvenience Clinical Skills Assessment Can we get outside the box? Don’t Be Intimidated • Your assessment will be part of a larger portfolio of physician performance Define what clinical skills you want to evaluate Considerations in building an assessment • Data Collection • Data Analysis • Feedback • Buy-in