title: How to develop a competency-based examination blueprint for longitudinal standardized patient clinical skills assessments.
abstract: BACKGROUND
  Objective Structured Clinical Exams (OSCEs) with standardized patients (SPs) are commonly used in medical education to assess learners' clinical skills. However, assessments are often discrete rather than intentionally developmentally sequenced.
  
  
  OBJECTIVE
  We developed an examination blueprint to optimize assessment and feedback to learners with purposeful sequence as a series of longitudinally integrated assessments based on performance milestones. Integrated and progressive clinical skills assessments offer several benefits: assessment of skill development over time, systematic identification of learning needs, data for individualized feedback and learning plans, and baseline reference points for reassessment.
  
  
  METHODS
  Using a competency-based medical education (CBME) framework, we translated pre-determined competency milestones for medical students' patient encounters into a four-year SP-based OSCE examination blueprint.
  
  
  RESULTS
  Initial evaluation of cases using the blueprint revealed opportunities to target less frequently assessed competencies and to align assessments with milestones for each year.
  
  
  CONCLUSIONS
  The examination blueprint can guide ongoing SP-based OSCE case design. Future iterations of examination blueprints can incorporate lessons learnt from evaluation data and student feedback.
authors.affiliation: University of Washington School of Medicine , USA.
authors.forename: Somnath
authors.initials: S
authors.lastname: Mookherjee
authors.forename: Anna
authors.initials: A
authors.lastname: Chang
authors.forename: Christy K
authors.initials: CK
authors.lastname: Boscardin
authors.forename: Karen E
authors.initials: KE
authors.lastname: Hauer
mesh_terms: D002983:Clinical Competence; D003142:Communication; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D010819:Physician's Role; D018794:Problem-Based Learning; D012577:Schools, Medical