Predicting Failing Performance on a Standardized Patient Clinical Performance Examination: The Importance of Communication and Professionalism Skills Deficits

Background The purpose is to determine which assessment measures identify medical students at risk of failing a clinical performance examination (CPX). Method Retrospective case-control, multiyear design, contingency table analysis, n = 149. Results We identified two predictors of CPX failure in patient-physician interaction skills: low clerkship ratings (odds ratio 1.79, P = .008) and student progress review for communication or professionalism concerns (odds ratio 2.64, P = .002). No assessments predicted CPX failure in clinical skills. Conclusions Performance concerns in communication and professionalism identify students at risk of failing the patient-physician interaction portion of a CPX. This correlation suggests that both faculty and standardized patients can detect noncognitive traits predictive of failing performance. Early identification of these students may allow for development of a structured supplemental curriculum with increased opportunities for practice and feedback. The lack of predictors in the clinical skills portion suggests limited faculty observation or feedback.