Abstract:

Introduction:
Standardized Patients (SPs) were first introduced in 1963 and have since become an essential method in teaching and assessing clinical skills for medical students. Consequently, the selection and thorough training of SPs have gained increasing attention. This study focuses on the training program for SPs to become raters in the Objective Structured Clinical Examination (OSCE) format, specifically at the Metered Dose Inhaler (MDI) instruction station for third-year medical students at Center for Elaboration Competency & Innovation in Clinical Simulation of Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam. (CECICS-PNTU)

Background:
This study investigates the efficacy of the SP selection and training program in preparing them to become raters. It explores whether SPs can replace faculty in formative assessment and providing feedback to students. If successful, this research could contribute to optimizing faculty resources, enhancing the role of SPs, and improving the quality of teaching, learning, and assessment.

Methods:
The SP selection and training program was implemented at the OSCE MDI formative model station. Two pairs of SPs participated in scoring checklists, but only the SPs interacting directly with students provided feedback. Additionally, four faculty participated in scoring checklists for twenty medical students. The analysis included assessing inter-rater reliability and comparing average values between evaluator pairs. Bland-Altman plots were utilized to compare the assessment methods between SPs and faculty.

Results:
The results indicated a high overall inter-rater reliability and no statistically significant discrepancies in average values between evaluator pairs. Most of the mean-difference scores between SPs and faculty fell within the limits of the Bland-Altman plot with a 95% confidence interval.

Conclusions:
Our study provides compelling evidence that the SPs-to-raters training program at CECICS-PNTU has yielded consistently positive and reliable outcomes. The performance of SPs has proven to be on par with that of FMs. Consequently, SPs can serve as effective alternatives to FMs in the formative assessment and feedback processes for OSCE MDI. This successful model holds promise for further extension, allowing for the utilization of SPs in the assessment of a wide range of clinical skills at CECICS-PNTU.

Keywords:

Standardized Patient, OSCE, Metered Dose Inhaler (MDI), formative assessment, inter-rater reliability, Bland-Altman plot.