How can simulated patients' experiences suggest ways to improve candidate performance in the MRCGP clinical assessments?

ABSTRACT

BACKGROUND: Candidates sitting UK postgraduate clinical assessments in general practice see 'patients' in a 'simulated surgery'. These simulated patients (SP) are actors specifically trained for this role. AIM: To describe SP experiences of postgraduate clinical exams in UK general practice. METHOD: Focus-group discussions and questionnaires of SP attending the RCGP's Simulated Surgery examinations were conducted in 2006/2007, followed by in-depth, one-to-one, semi-structured interviews with nine SP attending the MRCGP Clinical Skills Assessment (CSA) in 2010. RESULTS: SP opinions about the assessments, their ability to portray a range of 'patients' realistically and their opinions of candidate performance were explored. They were confident they could play a wide range of different cases, and had clear views as to what made 'good' or 'poor' candidates. The most frequently mentioned positive characteristic was 'listening'. Owing to the clinical nature of the examination, they did not feel able to mark or give feedback to candidates. They made general observations about consulting behaviour in the examination, and suggested some novel approaches to improving performance. CONCLUSIONS: Further research on the information SP glean about candidates could help guide learning and preparation prior to clinical examinations. This will be of particular importance in preparing candidates identified as performing less well in their training posts.