New Medical Licensing Examination Using Computer-based Case Simulations and Standardized Patients

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Abstract
To evaluate a new method, used for the first time in Italy, of administering the Medical Licensing Examination (MLE). Eighty medical school graduates taking the MLE were studied. The MLE was based on the Multimedia Integrated Pilot Project (MIPP), a single two-step examination that combines computer-based case simulations (step 1) and clinical encounters using standardized patients (step 2). Step 1 assessed mainly clinical knowledge and decision-making skills. Step 2 measured the ability to obtain a focused history, perform a relevant physical examination, prioritize a differential diagnosis and management plan, and provide patient education or counseling. The correlations between the total MIPP scores and the exam scores students obtained during the six-year medical school curriculum were evaluated. The step 1, step 2, and total MIPP scores were moderately correlated with the curriculum scores. A moderate correlation also existed between the scores reported in step 1 and those of step 2. The MIPP is a good tool for assessing clinical competence. Internationally, computer-based and standardized patient assessments are being used more often in licensing examinations. Continuous use of this method could improve medical graduates' performances.